From improper handwashing to compact living conditions, colleges have become a hotbed for bacteria and germs.

As a result, it’s not uncommon to see an outbreak of flu, upper respiratory or intestinal illnesses. Conditions that are less common but more debilitating are bacterial meningitis and mononucleosis, or mono.

“There are a variety of ways college students pass germs – coughing, sneezing or even using public door handles,” said Hilary Thompson , a physician assistant at Novant Health Seaside Family Medicine . “When one student spreads saliva to another they are spreading germs. Unfortunately, it’s not uncommon for students to share drinking glasses, utensils or even personal hygiene products like mouthwash and tooth brushes.”

According to the National Meningitis Association, approximately 600 to 1,000 people contract meningitis each year and 21 percent of those cases occur in preteens, teens and young adults. Historically, the number of cases would fluctuate from year to year but the number of cases is decreasing thanks to the introduction of meningitis vaccines.

“Meningitis is fairly rare due to the fact that we have been vaccinating individuals for the three most common strains as children for decades,” said Adam Thompson , also a physician assistant at Novant Health Seaside Family Medicine. “However, even though individuals are diagnosed with meningitis less frequently, it certainly hasn’t been eradicated. Everyone should still take precautions to avoid become infected.”

Mononucleosis is far more prevalent in college students than meningitis. There are nearly 3 million cases of mononucleosis each year.

“The symptoms associated with mono are similar to other viral infections – sore throat, fatigue, headache and body aches,” Hilary Thompson said. “Since mono is a viral infection, the only course of treatment is to address the symptoms, which can occur up to four to six weeks. However, individuals with mono can continue to spread the germs up to six months after becoming infected.”

She recommends that athletes and those with a weakened immune system take a blood test to confirm if they have mononucleosis. “Mono sometimes causes an individual’s spleen to become enlarged, which can rupture from a direct blow or trauma and cause further health complications,” she said. “For this reason, individuals with mono should not play contact sports and should avoid rigorous activities.”

The reason for the higher occurrence of mononucleosis over meningitis may be due to the fact that a vaccine is currently unavailable for the Epstein-Barr virus – the most common cause of mono. Research led by the National Institute of Allergy and Infectious Diseases aims to formulate a vaccine for Epstein-Barr. So far, say researchers, the results have been very promising, but the vaccine has only been tested in mice. There is still a great deal of work to do before it can be used in humans.

There are some basic measures teenagers and young adults should take to reduce the spread of germs.

“Never share personal hygiene products, drinks or other items that have come in contact with another person’s saliva,” Adam Thompson said. “The other greatest way to reduce the spread of germs is proper hand hygiene. It’s paramount. Wash your hands after using the bathroom, before and after touching food and any other time you believe you have come in contact with germs. It’s better to be safe than sorry.”