<p>Centers for Disease Control and Prevention took a more proactive stance to prevent the spread of meningococcal meningitis last week by issuing a recommendation that all children over the age of 11 be immunized against the potentially fatal disease with a newly licensed vaccine. </p>
<p>Many colleges already suggest that students receive either vaccination or information about meningitis, but the new federal recommendation makes it much more likely that a student's health-insurance plan will cover the cost of vaccination. In most states, insurance companies are required by law to cover the cost of any vaccine that is officially recommended by the Centers for Disease Control. </p>
<p>The CDC's new policy specifically recommends that college freshmen living in dormitories receive the vaccine. </p>
<p>College students have long been considered more likely than other people to contract meningitis because they tend to live in communal housing. Ten states already require students to show proof of immunization against meningitis or to sign a waiver form indicating that they have been informed about the disease. </p>
<p>From 5 to 15 students die each year from meningitis, and 12 to 20 more suffer permanent hearing loss, brain damage, or loss of limbs. Despite the relatively small number of meningitis cases, the disease has a high profile because deaths occur suddenly and unexpectedly; early symptoms are frequently mistaken for the common cold or the flu. </p>
<p>By the time meningitis is diagnosed, it can be too late to save the victims, as some forms of the disease rapidly eat away at the flesh and destroy the brain. </p>
<p>Many colleges, however, have been reluctant to require students to be immunized because the available vaccine, marketed as Menomune, was expensive and somewhat ineffective. But an improved vaccine, marketed as Menactra, was approved by the U.S. Food and Drug Administration in January, and that was one of the principal reasons the Centers for Disease Control changed its stance, according to Phillip L. Barkley, a member of the American College Health Association's task force on vaccine and preventable disease. </p>
<p>Although Menactra is more expensive than the vaccine it has succeeded -- it costs about $100 per dose -- one shot is expected to inoculate a patient for 7 to 10 years. Menomune was estimated to offer protection for only three to five years. </p>
<p>The new vaccine is also better because it eliminates the bacterium that causes the disease. Meningitis experts estimate that 10 to 30 percent of people naturally carry meningitis bacteria in their nasal mucus and inadvertently spread the disease to people who are not immune to it. </p>
<p>College health officials say the new federal recommendation has prompted them to become much more aggressive in educating students about the vaccine. Many more institutions are expected to make the vaccine mandatory. </p>
<p>"If they don't require it, they are putting themselves in legal jeopardy if a student dies," said Margaret Rennels, chairwoman of the infectious-disease committee of the American Academy of Pediatrics. "Whenever there's an official recommendation, it increases medical legal liability." </p>
<p>At the University of Florida, Dr. Barkley, who also serves as director of the campus health center, has already shifted gears. Before the CDC's recommendation, the State of Florida gave students the choice of getting vaccinated or being educated about the disease. Information packets sent to new students and their parents this year will take a different tone. </p>
<p>"We used to tell students and their parents that they need to be aware of this disease and understand a vaccination is available," said Dr. Barkley. "Now we're telling them that it is strongly recommended that they get the vaccine, and we're seeing a lot more students receiving it." </p>
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<p>Background articles from The Chronicle:</p>