The killer stalking campuses

December 19, 1997

Howard Newby describes how Southampton University responded to the death from meningitis of three first-year students

Last year it was Cardiff, this year Southampton; next year...? Such is the lottery of meningitis that it could be you.

Last month's outbreak in Southampton was the worst so far in a British university. It was a traumatic time. Over three weeks, three first-year students died and three other students with confirmed cases of meningitis were treated in hospital. The university's response was three-pronged: to contain the spread of the disease by taking informed decisions with expert medical advice; to maintain active lines of communication with our 17,000 students, their understandably concerned parents, and the university's 4,400 staff; and to provide continuing support to all those affected, including the bereaved families and friends.

Regular meetings were held between university staff and a medical team from the Southampton Communicable Diseases Control. We knew that it was essential to maintain control of events to counter any widespread rumours and panic. Through our contacts with the CDC team, we were aware that the medical decisions could be revised in the light of circumstances: for example, the emergence of further cases outside the identified "risk" groups, or new information on the strains of meningitis involved. It was important that we communicated this information clearly and with authority.

Our information strategy for the university community included setting up a meningitis website on the Net, which received more than 12,500 hits, and using email for urgent announcements. Posters and leaflets were distributed, meetings organised and three special newsletters produced in six days. The National Meningitis Trust was able to divert its mobile information centre to campus twice.

Effective media liaison also played its part. While concerned to protect the privacy of the families of our students who died, and those others in hospital, the university adopted an open-access policy for journalists, believing that accurate and full reporting in the media served the best interests of everyone. This involved me constantly being available to speak to journalists, otherwise they might move on to others and the ability to manage the news process would be lost. Our experience was that more, rather than less, information was helpful. There is nothing lost in speaking frankly and openly about difficult policy and practical issues.

The media responded constructively. Parents were probably the most difficult group to reach, especially overseas parents. A telephone helpline was set up and volunteer operators from the university and health authority provided staff from 8am until 11pm. More than 2,500 calls were taken by the Helpline in two weeks, and while it was an exhausting and often emotional process, the feedback was positive. Many parents were grateful for information on action to combat the spread of the disease and to hear that the risks of contracting meningitis were small.

Some overseas parents flew to Southampton to find out for themselves, and were reassured to find no signs of panic, that lectures and other events were proceeding as normal, and that our students were responding well to the information and advice. It was clear, however, that some parents were still struggling to cope with the loss. Their own sense of bereavement compounded their fear of this little understood disease.

The response from the wider community was mixed. Some of our arts venues received ticket returns, and recruitment visits were cancelled, despite reassurances that visitors were at no greater risk of contracting the disease on campus than anywhere else. Inevitably there was a wish to attribute blame. Stressed individuals can be very irrational. The vice chancellor is the lightning conductor in this process.

This reaction was far outweighed by the huge support we received, some of it from unexpected sources, not least from journalists. Perhaps as a result of the good media relations, most of the journalists who visited the university sympathised with the complexities of the situation and reported on it with sensitivity.

The response from health service staff at all levels in Southampton was exceptional, with touching gestures from all quarters. For example, the National Blood Service refused to postpone a scheduled visit to campus despite reduced donations, in order to show their support. We were greatly encouraged by the calm and responsible behaviour of our students, and perhaps most importantly, the university is indebted to many members of staff who saw little of their own families for two weeks to help ensure support and advice.

After the three weeks, more than 8,000 students and about 1,000 staff had received immunisations against strain C meningococcal meningitis - the one identified in all six cases. Since then pathological tests have established that the first student to die of meningitis was infected by a different sub-type of the C strain from the other five cases. No scientific link existed between her death and the other cases.

Over coming months a fuller analysis of the Southampton outbreak will be made. We are considering routine immunisation of all first-year undergraduates. Our interests differ from those of the NHS, however. Universities must convince staff, students and (especially) parents that they are safe environments and that we are effective carers (whatever the strict legal position). Confidence in the university is a primary concern. This needs to be recognised in future national guidelines.

We can never be complacent. As we now know, meningitis strikes suddenly, insidiously, with no warning and no subsequent cause or explanation. The fact that fit, healthy, and switched-on young people can die so quickly defies belief.

Under these circumstances there is a natural tendency for students to want to go home for the duration of the outbreak where they will feel safe. Many students are under parental pressure to do so. But this holds its own dangers. How many family GPs have seen a case of meningitis, a disease notoriously difficult to diagnose?

There is hope on the horizon: university research is likely to produce effective vaccines over coming years. For anyone in higher education this cannot come a moment too soon.

Howard Newby is vice chancellor of the University of Southampton.

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