Wednesday, April 4, 2018

Meningitis on Campus - An Extremely Timely Lecture by a Public Health Nurse Extraordinaire

Yesterday was the final guest lecture in my Humanitarian Logistics and Healthcare class this semester at the Isenberg School and it was extremely timely and interesting.

The students and I had the privilege of hearing from Ms. Ann Becker, who is the University Health Services (UHS) Public Health Nurse and the Unit Coordinator for the Medical Reserve Corps at  UMass Amherst.
The title of her guest lecture was: Meningitis on Campus - Reaching Students During a Meningitis-B Outbreak.

As some of you may have heard, this past Fall there were two cases of Meningits-B, one in late October, and the other three weeks after. Since no linkages between the two cases could be identified, the Centers for Disease Control (CDC) termed these cases an outbreak. Students get vaccinated for other strains regularly but not for the B strain. And, in early March, the CDC confirmed that another case was diagnosed in a Smith College student, so this is now a 5 College outbreak. 

This disease is very rare but it can progress rapidly with extremely dire effects.  I remember last semester when I was teaching my Transportation and Logistics class at the Isenberg School that one of the students in this class knew the first student to contract meningitis-B because they were both in the same fraternity, and he was involved in helping to raise funds for the student's care and recovery.

10-40% of 16-24 year olds are carriers of this bacteria, and the illness is transmitted through direct contact with secretions. Risk factors include large parties and sharing of drinks, cigarettes, etc., and being stressed and not sleeping enough only increases the probability of contagion. It takes at least a week to identify the meningitis strain from a culture and these were sent both to the Massachusetts DPH and the CDC.

The UMass Amherst campus responded extremely professionally. There had actually been simulation exercises in place for a mass vaccination and I had even blogged about this. This was inspired by the cases in the US a few years back on college campuses, including Princeton University. And, at that time, there was not even a vaccine available in the US (but was in Europe). 

The UMass Amherst campus responded with an emergency call center, since, once the news went out, the staff was inundated with calls. Staffing was identified for the initial vaccination clinics and vaccine supply and cold storage had to be managed. It was interesting to hear that the annual flu clinics also served as a prep for the mass vaccination clinics. UMass Amherst, as a university, is in the business of education, and it was essential to have no disruptions to courses. The healthcare staff, with assistance from nursing students and the Medical Reserve Corp, in 3 hours gave 700 vaccinations. "Being prepared and knowing people" helped in the efficiency of the processes as well as their effectiveness. The cost for 10,000 doses was $1.5 million from Glaxo Smith.

In order to reach students, there were numerous communication media that were utilized - from social media and emails to the notification of parents and having a dedicated strip banner with info on the UMass homepage. Also, the MA DPH sent out messages to every healthcare provider in the state. Two shots are required for the vaccine and there was a one week Thanksgiving break in late November with some students also getting their first vaccines from their home healthcare providers.

UMass Amherst had 4 walkin clinics over consecutive days from noon until 6PM and Ms. Becker showed the class an excellent diagram with the flow of the process, which is something all the Operations students enjoyed and appreciated. It began with the registration and asking for the insurance (if students or insurers could not pay, then (bravo) UMass Amherst covered the expense). Impressively, the number vaccinated reached 1,500 per day with the longest wait time of 20 minutes, which is not bad, given the volume of students as well as the severity of the disease.

It was interesting to hear that the processes were aided by the youth of those vaccinated and that they were all ambulatory.
There are still unknowns, however, since we don't have an accurate count of how many students have received the two shots that are needed, as Ms. Becker pointed out in her lecture.  Interestingly, she also mentioned that, after a year of no more outbreaks, can we be considered "in the clear." They do know that more than 3,000 + students have already had 2 shots.

Our University Health Services are continuing with walk-in clinics, which is great and also reassuring, and they have also done an amazing job in educating students as to proper behavior so that this bacteria does not spread.

We presented our fabulous guest lecturer with a certificate and a gift from the Isenberg School and took the group photo below as a memento.

And, in her last slide of her presentation, featured above, we can see our Chancellor, Dr. Kumble Subbaswamy, "saying": Get Vaccinated.

It was very special to have Ms. Becker speak to my class and her expertise and kindness are truly inspiring. We are very lucky to have her at UHS at UMass Amherst!