Meningococcal disease is a severe but uncommon infection that occurs when meningococcal bacteria invade the body from the throat or nose. At any given time, meningococcal bacteria are carried harmlessly at the back of the throat or in the nose in about 10% of the community. Although most people who have these bacteria in their throat or nose remain quite well, they are able to spread the bacteria to others, and a few of these people may subsequently become ill.
Meningococcal disease occurs in two main forms (or a combination of these two forms):
- meningococcal meningitis - when the bacteria infect the lining around the brain and spinal cord
- meningococcal septicaemia - when the bacteria invade the bloodstream and cause blood poisoning.
The symptoms of meningococcal disease don’t appear in any particular order and may appear differently in different people. Typical symptoms of meningococcal disease are listed below:
Symptoms in babies
- fever, hands and feet may also feel cold
- refusing feeds or vomiting
- high pitched moaning cry or whimpering
- dislike of being handled, fretful
- rash of red-purple spots or bruises
- blank and staring expression
- bulging fontanelle
- difficult to wake, lethargic
- pale blotchy complexion
Symptoms in older children and adults
- stiff neck
- dislike of bright lights
- joint pain
- rash of red-purple spots or bruises
A person with meningococcal disease usually needs to be admitted to hospital for appropriate care and treated with antibiotics.Control
Close contacts of a person with meningococcal disease have an increased, although still quite low, risk of also developing the disease. As a precaution, public health authorities identify contacts to explain the nature of the disease, and if necessary, prescribe a short course of antibiotics to get rid of any meningococcal bacteria they may be carrying in their throat or nose. In general, only household contacts and other close household like contacts (such as sexual partners) require antibiotics.
Vaccination is also recommended for any recent household, household-like and sexual contacts of people infected with certain strains of meningococcal disease which are preventable through vaccination. When test results are available, public health authorities will inform all contacts and advise them if the strain is vaccine preventable and if so to be promptly vaccinated by a general practitioner. Because antibiotics and vaccination may not always prevent meningococcal disease, all contacts, whether or not they have been given antibiotics or vaccination, need to be alert for the symptoms of the disease for around 2 weeks after their last contact with the infected person (see the meningococcal disease symptom chart under Other Resources). If any symptoms of meningococcal disease develop in close contacts or people close to them, it is important to seek urgent medical advice.
Anyone who has been in contact with a person diagnosed
with meningococcal disease is able to continue to attend child care, school or
work, and all other activities should continue as normal, whether or not they
have received antibiotics or vaccination.
After exposure to the bacteria, it usually takes from three to four days to become ill, although sometimes it can be as little as one day or as long as 10 days.
Some types of meningococcal disease can be prevented with immunisation. There are a number of different strains of meningococcal bacteria. The main strains that cause meningococcal disease worldwide are A, B, C, W135 and Y. In Australia, B and C strains are responsible for the majority of cases of meningococcal disease.
In Australia there are three types of vaccines available that provide protection against meningococcal disease:
- a vaccine that provides protection against the C
- a vaccine that provides protection for A, C, W135 and Y strains
A vaccine against infections caused by group B meningococcal strains, Bexsero®, has been available for purchase on the private market in Australia since March 2014.
Bexsero® is registered for use in children two months and older and is recommended for use by the Australian Technical Advisory Group on Immunisation (ATAGI) [http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/atagi-advice-bexsero] for specific groups at higher risk of infection.
The vaccine is not currently on the National Immunisation Schedule; for more information visit your GP or immunisation provider.
Immunisation against the meningococcal C strain is recommended as part of the National Immunisation Program Schedule and the vaccine is available free for all children at 12 months of age.
Like all medications, vaccines may have side effects. Most side effects are minor, last a short time and do not lead to any long-term problems. Possible side effects of meningococcal C vaccine may include soreness, redness and swelling where the injection was given, fever, loss of appetite and headache. These side effects should last only for a short time. More serious side effects are extremely rare. Contact your immunisation provider if you or your child has a reaction following vaccination which you consider serious or unexpected.
Smoking increases the chance of someone carrying the bacteria and spreading it to others. It is especially important not to smoke around young children who are particularly vulnerable to meningococcal disease.
Heymann, D., ed. 2015. Control of Communicable Diseases Manual, 20th edition. Washington, DC: American Public Health Association.
Australian Government, 2013. The Australian Immunisation Handbook (10th Ed.)