What Is Meningococcal Disease
Meningococcal disease is caused by a bacterial infection and can lead to serious illness and death. While generally an uncommon condition across the main populace, it occurs more often in winter and spring in Australia, with infants, small children, adolescents, and young adults placed most at risk. Early recognition of the signs and symptoms and immediate treatment are vital in preventing fatalities.
Meningococcal Disease Further Explained
Meningococcal disease is a serious illness that causes inflammation in the lining of the brain and spinal cord called meningitis. Rare forms of the disease include septic arthritis (joint infection), pneumonia (lung infection) and conjunctivitis (infection of the outer lining of the eye and eyelid).
People with meningococcal disease can become extremely unwell very quickly.
Ten per cent of patients with meningococcal disease die, even despite rapid treatment.
Historically, winter and spring have been the peak seasons for meningococcal disease outbreaks. However, cases can occur year-round.
Meningococcal disease is caused by infection with Neisseria meningitis, of which there are several serogroups. The disease is caused by serogroups A, B, C, W and Y. The introduction of the meningococcal C vaccine has reduced the number of cases caused by that serogroup.
One in every ten people carries meningococcal bacteria at the back of their nose and throat without showing any illness or symptoms. It naturally resides in the ideal conditions without causing problems to the host.
What Are The Symptoms Of Meningococcal Disease
Symptoms identifying the presence of the meningococcal disease may include several of the following:
- A rash of red-purple spots or bruises
- Sudden onset of fever
- Headache
- Neck stiffness
- Joint pain
- Dislike of bright lights
- Nausea and vomiting
Young children may display less specific symptoms:
- Irritability
- Difficulty waking
- High-pitched crying
- Refusal to eat and lack of interest in food
- One, many, or all symptoms may present as the condition worsens
The meningococcal rash typically does not disappear with the application of gentle pressure to the skin. Not all people with meningococcal disease will present with a rash initially. The tell-tale red/purple rash may occur later as the disease progresses and the patient declines.
Sometimes the classic symptoms may follow a string of less specific symptoms, including leg pain, cold hands, and abnormal skin colour.
Other respiratory infections can sometimes activate meningococcal disease in people who naturally carry it in their nose or throat.
People with meningococcal disease symptoms should see a doctor urgently, especially if there is persistent fever, irritability, drowsiness or lethargy, a child is not feeding normally, or several of the symptoms have come on or worsened quickly.
If you have already seen a doctor, but symptoms continue to worsen, go to the Emergency Department closest to you for a secondary assessment.
How Is Meningococcal Spread
Meningococcal bacteria are not easily spread from person to person, and the bacteria do not survive for long outside the optimal conditions or the human body.
The bacteria are passed between people via the saliva or mucus secretions from the back of the nose and throat. This generally requires intimate and prolonged contact with the person carrying the bacteria. Ironically, the carrier is usually completely well and oblivious to them being the host. An example of ‘close and prolonged contact is sharing food from the same utensils or intimate (deep) kissing.
Parent-to-infant exchanges occur when the parent places food for the baby into their mouth first, usually to test for temperature and taste, then inserts it into the baby, who contracts the disease and begins the process of onset meningitis that ensues over the following hours.
Meningococcal bacteria can be, but are not, easily spread by sharing straws or cigarettes.
What Are The Risk Factors For Meningococcal Disease
Meningococcal disease can affect anyone of any age. However, there are certain higher-risk groups that may include:
- Household contacts of patients with meningococcal disease
- Infants, small children, adolescents, and young adults
- People who smoke or are exposed to tobacco smoke
- People who practice intimate (deep mouth) kissing, especially with more than one partner
- People who have recently had a viral upper respiratory tract illness
- Travellers to countries with high rates of meningococcal disease
- People with no working spleen or who have certain other rare medical conditions.
- People who have had minor exposure to someone with meningococcal disease have a very low risk of developing the disease.
Healthcare workers do not present at increased risk unless they have been directly exposed to an infected person’s nasopharyngeal secretions via mouth-to-mouth resuscitation or intubated the case without using a face mask.
How Is Meningococcal Disease Prevented
Vaccination is the suggested prevention measure against meningococcal disease for people who do not carry the bacteria naturally. There are two meningococcal vaccines available:
- Meningococcal ACWY (Men ACWY) vaccine that protects against serogroups A, C, W and Y.
- Meningococcal B (Men B) vaccine that protects against some strains of meningococcal serogroup B.
Routine childhood vaccines do not protect against all strains of meningococcal disease, nor have any effect on natural carriers of the bacteria. People must still be alert for the symptoms and signs of meningococcal disease, even if vaccinated, as mutated strains can naturally occur.
Government Recommendations
- Any person from 6 weeks of age who wants to protect themselves against meningococcal disease is recommended to receive the two vaccines available in Australia.
- Infants and children under two years, adolescents, and people with certain medical conditions are strongly recommended to receive both meningococcal vaccines.
- Meningococcal ACWY vaccine is required for pilgrims to the Hajj and strongly recommended for persons travelling to areas where epidemics of meningococcal A, C, W and Y occur, such as the meningitis belt of sub-Saharan Africa. Talk to your travel doctor or General Practitioner for up-to-date vaccination requirements.
- Men ACWY and Men B vaccines, such as for laboratory workers, are also recommended for people at occupational risk of meningococcal diseases.
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