Responses to a Meningitis B Outbreak: A Princeton Experience

Abstract

Bacterial meningitis is a particularly devastating and debilitating disease with relatively high mortality and morbidity rates even in developed countries like the United States. One of the major causative agents, Neisseria meningitidis is a bacteria with several vaccines that target it included in the national immunization program. However, licensed vaccines in the United States do not cover all serogroups of N. meningitidis. Immunization against serogroup B is difficult with the means of transmission stemming from poor hygienic measures, leading to children and adolescents being exceptionally susceptible to infection by serotype B. Recently, researchers have developed several alternative vaccines targeting outer membrane antigens of N. meningitidis. One of these vaccines, Bexsero, was used to treat thousands across the country in two simultaneous outbreaks at Princeton University and University of California, Santa Barbara in 2013-­‐2014. Starting in March 2013 and lasting over a year, the Princeton University outbreak totaled nine cases and one fatality. Due to the threat of a more widespread epidemic, the University's administration consulted with the Center for Disease Control and Prevention and U.S. Food and Drug Administration to eventually import the unlicensed vaccine from Europe. Before examining the storylines of the Princeton outbreak and the distribution of Bexsero, this thesis reviews the bacteria and disease that elevated Princeton, meningitis B outbreaks and experimental vaccines into the national spotlight.