College reacts to possible outbreak
The administration of free vaccinations for the meningococcus bacteria began yesterday in Alumni Hall in response to the sudden death of Jenica Rosekrans '00 and the confirmation of sophomore Nicolas Calamari's infection.
According to Associate Director for Business Affairs Yolanda Baumgartner, approximately 950 students received vaccinations yesterday, out of an estimated 1,400 to 2,000 recipients eligible. Vaccinations will continue today from 9 a.m. to 5 p.m. in Alumni Hall.
Dr. Nield Mercer of College Health Services said the decision to administer free vaccinations to students was made by the New Hampshire State Health Department. Mercer said the Department asserted that there is no significant risk for campus residents this summer, but "they thought it was a fair thing to do for people nervous about [the disease]."
According to Public Health Nurse Coordinator Thomas Marsh, meningococcal disease is one that New Hampshire requires by law to be reported to the State Health Department. When a disease is reported, the Department takes cultures and analyzes the bacteria to determine its type and strain.
After the College reported the meningococcus outbreak, the Department became interested because of the number of confirmed cases.
"One [case] will pop up sporadically for reasons unknown," said Marsh. "But when more than one pops up, it causes concern."
Immediately after Rosekrans's death, the particular strain of the disease - there are three types: A, B and C - was unknown. Due to this uncertainty, state officials and College doctors could not decide whether vaccinations were appropriate, because the vaccine prevents the contraction of only the A and C strains of the bacteria.
Once doctors discovered that Rosekrans and Calamari suffered from strain C of the virus - the most deadly strain - the State Health Department, along with the Center for Disease Control and doctors at the Dartmouth-Hitchcock Medical Center, decided to recommend and pay for the vaccinations. Marsh said doctors were surprised to learn that the outbreak was strain C of the bacteria, because strain B is the most common.
Vaccinations are only recommended for students while College faculty and employees do not need to receive the injections. According to Dr. John Turco of College Health Services, the State Health Department chooses "at-risk groups" based on "a group of individuals, as opposed to a geographic location."
Turco said that faculty and employees have almost no chance of becoming infected because the disease is spread by "intimate contact." In addition, Turco said people over 30 years old have a much lower chance of becoming infected because of immunities built up during their life.
The meningococcus bacteria (Neisseria meningitidis) can cause meningitis (spinal column infection), bacteremia (blood infection), pneumonia (lung infection) and arthritis (joint infection). Symptoms of the bacterial infection include sudden high fever, chills, severe headache, stiff neck and back, painful joints, vomiting, extreme sleepiness, loss of consciousness, seizures and rashes.
Mercer said the chance of being infected by the disease is normally one or two in 100,000, but being on campus this term could increase that chance by a factor of 10.
Despite this, Mercer said the chance of becoming infected is less than the chance of a student's being hit by a car, but greater than the chance of being struck by lightning.
According to Mercer, while almost any student can be vaccinated, students who are pregnant, are allergic to thimerosal (a preservative in the vaccine) or have a fever of at least 101 degrees should avoid vaccination.
While the vaccination has few side effects, about two percent of recipients develop a fever after receiving the injection.
Acting Dean of the College Dan Nelson sent a BlitzMail message to the entire faculty and student body and an Express Mail letter to all students scheduled to be in residence for the Summer term stating that students could request that their summer residence requirement be waived.
Nelson told The Dartmouth yesterday that only five or six students made the decision not to be on campus for their Summer term. Although some families were alarmed to receive a message sent via Express Mail, Nelson said the administration "wanted to get information to students and their family as soon as possible."
Nelson said the administration considered completely canceling the Summer term, but the state Health Department told Nelson there was no need for such a drastic measure.
"This is an opportunity for students," Baumgartner said. She urged students to receive a vaccination because they cost no money and last for more than three years. Mercer said the free vaccinations are especially helpful for those who plan to travel to countries such as Nepal, Ethiopia, North Kenya or Sudan, due to the prevalence of meningitis in those countries.
Rosekrans died on June 10 after spending over 12 hours in the Dartmouth-Hitchcock Medical Center. Dr. Bryan Marsh, who treated Rosekrans for the last three hours of her life, said the student experienced abdominal pain, nausea and vomiting before being admitted to the hospital on the morning of June 10.
Dr. Marsh said that after her blood pressure dropped abruptly, Rosekrans was moved to the intensive care unit where Disseminated Intravascular Coagulation - an abnormality of blood clotting making patients unable to clot their own blood - made it difficult for doctors to stabilize her blood pressure.
Rosekrans was later sedated and placed on a breathing machine between 8:30 and 9 p.m. Dr. Marsh said she entered cardiac arrest a few hours later and died shortly after 11 p.m.