Saturday, November 27, 1999

By Jeff Donn, The Associated Press

AMHERST, Mass. -- Lawrence and Sharif Muhammad stood paralyzed by indecision at the doorstep of a University of Massachusetts vaccination clinic.

Their mom was worried about them catching meningococcal meningitis. She had heard that it can kill an otherwise healthy teen-ager in hours. Two students had already been stricken this fall at the university.

But they got better. And with 18,000 undergraduates at UMass-Amherst, how much of a threat was there really? Besides, at $75 a vaccination, the price looked pretty steep.

The Muhammad brothers finally turned around and left.

Spurred by the latest federal recommendations, colleges are mounting a widening attack on meningitis this fall with health advisories, educational campaigns and vaccination clinics. The aim is to curb the spread of meningitis in dormitories.

But the latest studies suggest that only a few meningitis deaths might be avoided each year in dorms -- leading some health authorities to wonder if they could do better by working against more common college scourges like drunken driving or sexually transmitted diseases.

"You're talking about millions of dollars per life saved. There are known to be many interventions in public health that do better than that," said Milton Weinstein, a risk expert at the Harvard School of Public Health. On his family doctor's advice, he is letting own 18-year-old son go unvaccinated at college.

Meningococcal meningitis is an infection of the membranes around the brain and spinal cord that can be spread by kissing or even sharing a drinking glass. The symptoms include fever, neck stiffness and headache. The disease kills in roughly 10 percent of cases and does serious harm, including brain damage, in another 10 percent.

The federal Centers for Disease Control and Prevention recommended last month that campuses give easy access to the meningitis vaccine, especially for college freshmen.

The vaccine is deemed 90 percent effective against 70 percent of college cases. In the remaining 30 percent of cases, the vaccine has no effect. Of 3,000 cases nationwide in a typical year, just 100 to 125 occur at colleges. The death rate is highest among freshmen living in dormitories. With about 520,000 such freshmen this fall, five deaths would be expected.

Figures on causes of death among college students are hard to find. However, in 1997, there were 10,208 road fatalities, 4,186 suicides and 276 AIDS deaths for young people ages 15 to 24, according to the National Center for Health Statistics.