These Go to Eleven: Our All-Star Lineup of College Illnesses

(Photo by Paul Culp)

By Paul Culp, MA (Oxon.), CFT, GCDF, CCSP

We recently published a post urging college students to be aware of the dangers of the virus and enjoining appropriate precautionary measures. The same conditions that can promote a flu outbreak on a college campus are equally conducive to the transmission of other illnesses, so we thought it wise to follow up with a discussion of other common collegiate maladies. Dormitory life, shared toilets and shower facilities, shared keyboards, communal dining, irregular hours, substandard eating habits, stress, and what one might call romantic adventures can all compromise the immune system and provide career opportunities for pernicious microbes.

It seems especially appropriate that the movie that gave us the expression “these go to eleven” is titled This is Spinal Tap.

We present, in no particular order, ten high-profile ailments that afflict college students, and one more as a bonus.

1. Meningococcal meningitis

This one seems to have a special place of honor among people who write about college illnesses, not because it is especially common but because it can be so destructive. Dr. Gerald Ryan, director of clinical services at the University of Wisconsin-Madison, explains that meningitis is “an infection of the space between the brain and the outer covering that envelops the brain, an area called the meninges.”

There are multiple types of meningitis—bacterial, viral, and fungal—most of which are relatively inconsequential, but according to Ryan’s counterpart at the University of Michigan, Dr. Robert D. Ernst, “Bacterial meningitis is potentially life-threatening or associated with permanent neurological damage.”

According to WebMD, about 20 percent of people who contract the disease experience serious complications, and the Centers for Disease Control report that 15 percent of survivors may experience permanent disabilities including deafness, brain damage, and other neurological disorders.

“Fortunately, meningococcal meningitis is not very common,” Ryan says, “but unfortunately it is very serious and has a high fatality rate.”

Symptoms may include general malaise, persistent headache, stiffness in the neck, fever, joint pain, rash, confusion, and unusual drowsiness.

Ryan recommends pre-enrollment vaccination for all college students. Younger students, especially freshmen, are at higher risk. Routine preventive measures are what one might expect: “Wash your hands frequently, don’t share eating or drinking utensils with others, and cover your mouth and nose with your elbow when you sneeze or cough.”

While viral meningitis tends to go away on its own within a week or so, early intervention is advisable to give a doctor the opportunity to rule out bacterial meningitis. Ernst says a doctor may prescribe antibiotics as a precaution, though a spinal tap may be necessary to rule out bacterial meningitis altogether.

2. MRSA

Our regular readers might recall ROTC Scholarships: Uncle Sam Wants You, and He Has Deep Pockets, (August 30) in which we featured a video clip of Andy Griffith, in No Time for Sergeants, learning that ROTC isn’t a disease. Alas, MRSA is very much a disease, methicillin-resistant Staphylococcus aureus, and it is every bit as formidable as the name sounds.

MRSA is something of a newcomer to the roll-call of collegiate health villains. Dr. Ernst describes it as “an emerging skin infection that we are seeing much more commonly.” The condition usually manifests itself first with small, pimple-like red bumps, which then escalate into painful pus-filled boils.

The Mayo Clinic recommends caution: “Sometimes the bacteria remain confined to the skin. But they can also burrow deep into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves, and lungs.”

We have bad science and irresponsible medicine to thank for what has been called a superbug, according to Mayo:

“MRSA is the result of decades of often unnecessary antibiotic use. For years, antibiotics have been prescribed for colds, flu, and other viral infections that don’t respond to these drugs. Even when antibiotics are used appropriately, they contribute to the rise of drug-resistant bacteria because they don’t destroy every germ they target. Bacteria live on an evolutionary fast track, so germs that survive treatment with one antibiotic soon learn to resist others.”

Contact with contaminated surfaces is the primary cause of transmission: “Gym equipment, locker rooms [and] towels are often implicated as sources of infection,” with swimming pools and whirlpools also being high-risk areas. Athletes in contact sports, of which open wounds are a regular feature, experience an incidence of infection far beyond the average.

Common sense is crucial to prevention: avoidance of towels, razors, and other personal items, conscientious use of spray disinfectants and alcohol-based sanitizers, and thorough wipedowns of gym equipment are essential. Frequent handwashing is of course de rigueur. Wounds should be kept bandaged, and persons with cuts or sores should launder towels and sheets frequently and in very hot water. Athletic clothing should be washed after every use.

The incentives to prevention are considerable. Antibiotic treatment apparently is a necessary but not sufficient condition for a cure. Ernst says most cases require an outpatient procedure in which a doctor removes pus from the boils. And then there are the possible complications. MRSA can cause permanent damage and even death.

3. Mononucleosis

“Mono,” also known as glandular fever where British English is spoken and as “the kissing disease” where colloquialisms and euphemisms are preferred, is common among teens and young adults. Usually caused by the Epstein-Barr virus, a highly sociable member of the herpes family, mono produces sore throat, fever, swollen lymph nodes, swollen tonsils, and in some cases rash or enlarged spleen, and it is notorious for inducing an extreme lassitude that can linger for months. The other symptoms tend to disappear on their own within two weeks. Treatment usually consists of fluids, rest, and over-the-counter pain medications. There is no vaccination.

Since mono is transmitted solely via direct contact with the bodily fluids of an infected person, usually saliva, prevention is best achieved by being fastidious about kissing, by not sharing beverages and foods, and by rudimentary precautions regarding coughing and sneezing. We think it unlikely that anybody who would use someone else’s toothbrush would be intelligent enough to visit our blog in the first place, but we realize that accidents do happen, in terms of both readership on the internet and mistaken toothbrush identity in shared bathrooms.

The incubation period after exposure to the virus can be of several weeks’ duration, so it may be desirable for some persons to exercise circumspection in the matter of whom to blame for their mononucleosis.

The good news is that mononucleosis is a one-to-a-customer illness; once you’ve had it, you will never have it again. But to conclude on a sour note: Since the virus is a type of herpes, those affected by it will never be rid of it and therefore can transmit it to others ever after.

4. Strep throat

If an ordinary sore throat is a Chevrolet, strep throat is a Mercedes, a sore throat deluxe. Caused by the bacterium Streptococcus pyogenes (which would have been a good name for one of Alexander’s generals), also known as group A streptococcus, strep throat tends to be extraordinarily uncomfortable and can lead to serious complications including kidney inflammation or rheumatic fever, the latter of which can lead in turn to painful and inflamed joints, rash, or damage to the heart valves, according to the Mayo Clinic.

Throat pain associated with strep tends to arrive abruptly and progress quickly. Other symptoms may include red spots on the palate, swollen lymph glands, fever, headache, rash, and body aches. Nausea and vomiting are rare in adults. The infection sometimes spreads to the tonsils, middle ear, sinuses, skin, or blood.

Treatable by antibiotics, since it is bacterial rather than viral, strep throat is highly contagious and can be transmitted via airborne droplets released by sneezing or coughing; shared utensils, foods, or beverages; direct contact with the saliva of person carrying the bacteria; or transfer of bacteria from unsanitary surfaces to the hands and then to the eyes, nose, or mouth. Persons transmitting the disease may be completely asymptomatic. Cleanliness is crucial to prevention. Surprise.

Winter and early spring are peak periods for strep throat, but it can occur at any time.

5. Conjunctivitis

This particularly lurid-looking condition, either bacterial or viral, is known colloquially as pink eye for obvious reasons. The transparent membrane that lines the eyelid and covers the white part of your eyeball is called the conjunctiva. When small blood vessels in the conjunctiva are inflamed or infected, they become more visible, imparting a pink or reddish appearance to the whites of the eyes. Conjunctivitis may appear by itself, but it often accompanies a sore throat or head cold.

“In general, bacterial conjunctivitis will produce a lot of yellow drainage [from the eye] all day long,” Wisconsin’s Dr. Ryan says. “With viral conjunctivitis, the person may have some crusting and discharge when they wake up in the morning, but during the day the drainage is usually watery and not thick and yellow.” A prescription for anti-bacterial eye drops can be helpful in resolving bacterial conjunctivitis, and artificial tears can ease the discomfort of the viral variant.

The condition usually runs its course within a few days, and clean hands are the most important element in prevention.

6. Flu

Not for nothing did we devote an entire post to flu (College, Flu, and You, October 4). Influenza is a serious matter, and its career as a mass killer is not necessarily a thing of the past. Last year’s flu season constituted an outright epidemic, with flu-related deaths reaching their highest levels since the inception of current reporting procedures. As we noted last time, one outbreak of flu exactly a century ago killed more people worldwide than the World Wars and the Holocaust combined.

To quote from our own work (always a gratifying experience), flu symptoms may include “fever, cough, stuffy or runny nose, body aches, sore throat, headaches, fatigue, and vomiting or diarrhea…Flu tends to move quickly after the onset of infection, and victims who delay treatment may become very seriously ill, perhaps lethally so, before intervention occurs. The CDC warns of flu-induced pneumonia, a common cause of flu-related deaths; inflammation of the heart, muscle, or brain; respiratory or kidney failure; and sepsis. People with diabetes, chronic heart disorders, asthma, and kidney disease are especially at risk, as are pregnant women.”

Vaccinations, though far from infallible, have proven generally effective, but college students have been slow to embrace them. A nasal mist is available for those who especially loathe needles.

Other preventive measures include cleanliness, getting adequate rest, and proper attention to diet.

7. Common Cold

More annoying than dangerous, the common cold is caused by a virus transmitted via through droplets in the air launched by sneezing, coughing, or talking, or via direct contact with contaminated persons, objects, or surfaces. The virus enters the body through the eyes, nose, or mouth. Unless you have been freakishly blessed, you know the symptoms: runny or stuffy nose, sneezing or possibly cough, mild fever and aches, headache, and upset stomach.

The primary risk with the common cold is that it can develop into a secondary infection in the sinuses, lungs, ears, or throat. The Mayo Clinic recommends seeking medical attention if the cold is accompanied by a fever higher than 101.3, if fever lasts for five days or more or if it returns after a fever-free period, if the patient experiences wheezing or shortness of breath, or if sore throat, headache, or sinus pain become severe.

Preventive measures include cleanliness, stress management, proper diet, and avoidance of sick people.

The medical and scientific communities are working with their might toward a cure, but the common cold is one of the most resilient and maddening of maladies. A biologist at a leading research university told me that she and her team had come painfully close to a cure on multiple occasions, only to have the virus reinvent itself and continue on its merry way.

8. Sinus infection

Sinusitis, an inflammation or swelling of the tissues lining the sinuses, is usually caused by the common cold but can be far more serious, possibly causing significant complications. Symptoms include obstructed breathing, heavy production of thick green or yellow mucus, headaches, and swelling or pressure around the eyes, forehead, and cheeks. Most cases resolve themselves within two weeks, but medical attention may be necessary if the condition persists. Over-the-counter nasal drops and sprays may be helpful, and in serious cases a doctor may prescribe antibiotics.

When in doubt, don’t be a hero. According to WebMD, “In rare cases, untreated sinusitis can lead to meningitis, a brain abscess, or an infection of the bone.”

A final word to the wise: Prolonged use of over-the-counter sprays and drops can lead to dependence on them and a resultant need for medical attention to enable the sinuses to recover their ability to function without chemical assistance.

9. Gastroenteritis

Commonly known as stomach flu (or by other, less complimentary names), gastroenteritis is not actually a type of flu but a different virus altogether, affecting only the gastrointestinal tract. Contaminated food and water are the prevalent agents of transmission, though direct person-to-person contact can also promote infection.

The most common symptom is diarrhea, though nausea and/or vomiting may also occur. Headaches, minor muscle aches, and low-grade fever are common. The disorder normally runs its course (no pun intended) in two to 10 days, with the most serious complication normally being dehydration caused by diarrhea. There is no effective treatment, and handwashing is the best preventive measure.

10. Food poisoning

There is some overlap between gastroenteritis and food poisoning, since the noroviruses that cause the former can be involved in the latter, but food-borne illness is dauntingly multicausal. As the Mayo Clinic explains, en route to listing 13 different possible contaminants, including noroviruses, “Contamination of food can happen at any point of production: growing, harvesting, processing, storing, shipping, or preparing. Cross-contamination — the transfer of harmful organisms from one surface to another — is often the cause.”

The potential for mass outbreaks in dining halls is obvious, but students preparing food on their own can cause mayhem with careless food-handling or by allowing foods to sit for too long at warm but not hot temperatures, a major risk in party situations. Canned commercial foods, luncheon meats and hot dogs, cream sauces, cream-filled pastries, and raw fruits and vegetables (such as one encounters on salad bars) are common culprits. Anything containing eggs is highly hazardous if not kept cold or very hot.

Preventive measures include handwashing, maintaining clean dishes and utensils, taking care to cook everything sufficiently, not leaving risky foods at room temperature or even slightly warm for long periods, and faithful observance of the old standby: When in doubt, throw it out.

Treatment normally is confined to rehydration, patience, and, if circumstances permit, willingness to forgo anti-diarrhea medications and let the body rid itself of toxins in the best way it knows how.

11. Athlete’s foot

The same fungus that causes ringworm is responsible for a dermal malady that can affect anyone who spends a lot of time in damp socks and/or tight shoes. Tinea pedis is also transmitted by contact with towels, mats, floors–especially in showers–swimming pools, and saunas. Because the fungus can travel on the hands or on a towel, it doesn’t confine itself to the feet, and often makes its abode on the hands or in the groin.

Typical symptoms include itching and a scaly rash. Blisters or ulcers may occur in severe cases. Though athlete’s foot is usually no more than a nuisance, persons with diabetes should see a doctor promptly if they think they have athlete’s foot.

Prevention is best achieved by keeping the feet dry and clean, using an antifungal powder daily, and wearing flip-flops or slides in communal showers. Treatment via over-the-counter sprays, powders, or ointments is usually sufficient, according to Mayo, but extreme cases may require prescription treatment including oral medication.

I went out for cross country as a high school freshman and caught athlete’s foot in the fieldhouse shower on my first day of practice, and I’d like to share the foolproof cure my dad learned in the Navy, but I’m afraid I would be sued for dispensing medical advice on the internet.

We’re concerned about college illnesses, and that includes the health of your application and finances.

The Coaching Educator does not purport to know everything about college life, including health matters, but we do our best to keep abreast of related trends and concerns. We have nearly a decade of experience helping students get into and succeed at the right college and obtain the financial aid they require, and we want to do everything we can to promote the optimal college experience. To learn more about our philosophy and capabilities, be sure to watch our free webinars, listen to our podcasts, sign up for our four-week College App Boot Camp, consider our Ultimate Programs and our special services for athletes and performing-arts students, and book a consultation to hear what we can do for you and how we do it. Keep reading this blog, and look for us on social media (see links below) as we keep our clients and admirers advised of new developments in our effort to help students get into and succeed at the right school.

Paul Culp is certified as a global career development facilitator and writes about college admissions, college costs, financial aid, and college life in general for The Coaching Educator team. A former journalist and corporate ghostwriter who now operates Shenandoah Proofreading, Editing & Composition Services (SPECS), he has also been a humanities teacher at all levels from university down to sixth grade. Paul has degrees from Oxford University, Jacksonville State University, and Samford University, and also is certified as a fitness trainer.