The return to campus exposes three student age groups - tweens (11- and 12-year-olds), teens and first-year college students - to a rare but fast-moving and potentially fatal disease: meningococcal meningitis.
About 2,000 Americans a year contract this bacterial form of meningitis, an infection of membranes around the brain and spinal cord, said Melinda Malone, a public-health nurse at San Juan Basin Health Department. It's an infection that can kill the same day it's contracted.
"It may appear abstract at this incident rate," Malone said. "But it's a catastrophe if it strikes in your family."
Malone remembers only one case of meningococcal meningitis in La Plata County. A few years ago, a teenager from Arizona arrived in Durango on a Sunday for spring break. He skied Monday and Tuesday and then partied Tuesday evening with friends he had made on the slopes.
"He woke up sick Wednesday morning and was dead by noon," Malone said.
Meningococcal meningitis is of enough concern that Fort Lewis College has a section addressing the disease in the contract that students living on campus sign, school spokesman Mitch Davis said. Students are made aware of the disease and that the campus health center has a vaccine available.
"It's a rare disease. No one here can remember a case on campus," Davis said. "If there ever were a case, we'd get the student to the hospital and then take a close look for anyone who had been in contact with the person."
Catherine Adams, a nurse at San Juan Basin Health and its immunization liaison to schools, said the Menactra vaccine was offered at Durango High School last year for the first time. She plans to visit middle schools this year.
"We vaccinated 32 for menin-gococcal meningitis," Adams said. "I think we'll do better this year."
The meningitis bacteria always is around, but the proximity of students in class, cafeteria, dormitory or automobile can expose them more readily to the bacteria from sneezing and coughing, Malone said. The bacteria also can pass from one student to another by sharing a soda.
"The incident rate increases as students get older," Malone said. "College freshmen are the most vulnerable."
It's an anomaly, but 15 percent of people are carriers of the disease but remain unaffected, Malone said.
"We don't know why they are carriers but don't get sick," Malone said. "They apparently have adapted to it."
Malone recommends children be vaccinated against meningococcal meningitis and hepatitis A as well as the tetanus-diphtheria-pertussis and smallpox shots that are required. She also recommends girls be vaccinated against the human papilloma virus.
"The HPV vaccine isn't given to boys," Malone said. "But they're doing clinical tests to see if it will work."
An Associated Press story out of Washington, D.C., says since the government recommended two years ago that all tweens and teens be vaccinated against meningococcal meningitis, about 40 percent have received the vaccine.
The report says about 15 percent of the 2,000 people who are struck with the disease each year die. About 20 percent of survivors are permanently incapacitated with deafness or brain damage.
Malone hopes worries about seasonal flu and the novel N1H1 virus, also called swine flu, don't overshadow the effort to get young people vaccinated against meningococcal meningitis.
"The symptoms of meningitis mimic the symptoms of flu," Malone said. "If meningitis isn't diagnosed correctly the first time, there might not be a second chance."