Meningococcal disease is a very uncommon illness and the majority of people who become infected make a complete recovery. But a small number of people who contract meningococcal disease will develop serious complications, and in a few cases, meningococcal disease can be fatal, or cause such severe damage to fingers and toes that amputation is necessary.
Meningococcal disease is caused by bacteria (germs) called meningococci, also known as Neisseria meningitidis, which normally reside in the back of the throat and are most likely to affect small children and young adults. The infection is passed on in fluids from the throat of an infected person, by sharing a drink bottle, a dummy or teat with an infected person, kissing them on the mouth, or by droplet transmission from a cough. Meningococci can cause: meningitis (an infection of the membranes covering the brain and spinal cord), septicaemia (a blood infection) or less commonly, joint infection or infection of the ears or eyes.
Although it affects only about 200 people a year in the NSW region, the end of winter and beginning of spring is the peak season for the disease, when around five to ten people become ill with it each week, although children less than five years of age and teenagers and young adults aged 15 to 24 years are most at risk.
There are many strains of meningococci, but the strains that cause almost all disease in Australia are serogroup B and serogroup C. Meningococci live naturally in the back of the throat in about 10 per cent of the population. People of any age can 'carry' the germs without becoming ill, and 'carriers' develop immunity to the strains they carry. Although everyone is a carrier at some time, carriers are most common amongst young adults, especially smokers. Meningococci cannot live for more than a few seconds outside the body, and are only found in humans. You cannot catch meningococcal germs from the water supply, swimming pools, animals or air conditioning in aeroplanes or buildings.
Meningococcal disease is uncommon. Most cases occur sporadically ('out of the blue') and are unrelated to any others. Outbreaks where more than one person is affected are uncommon. The symptoms of meningococcal disease include a high temperature, sometimes with chills, vomiting, sometimes with diarrhoea, a stiff or sore neck or back, headache and photophobia (dislike of bright lights), a rash on the skin, and sometimes, joint pain. The rash in septicaemia can look like small bruises, caused by bleeding into the skin, and the size of the spots may be anything from pinpricks to several centimetres across. There may be one or two, or there may be many, and they can occur anywhere on the body and they do not blanch when pressed.
Anyone with two or more of these symptoms, especially if there is a rash, should see a doctor immediately. It is very important that meningococcal disease is treated very early with antibiotics before serious problems occur. If meningococcal disease is suspected, an antibiotic is given immediately, by injection. People with meningococcal disease are always admitted to hospital. The earlier antibiotic and other treatments are begun, the less damage the disease will cause. However, this is a very serious infection, which can progress very rapidly despite the best treatment.
Very close contacts of an affected person are given a short course of oral antibiotics. These include members of the same household, girlfriends and boyfriends, and children in day care or pre-school centre where an affected person attends. Most contacts, such as school friends and workmates, do not need antibiotics unless they have shared a drink from the same cup or kissed an affected person on the mouth. Being in the same room as a person who develops meningococcal disease does not pose an increased risk. It is important to understand that these preventive antibiotics are very good at getting rid of meningococci from the throat, but they are not a treatment for meningococcal disease. You can lower your risk of meningococcal disease by discouraging smoking in your friends and family. Basic hygiene can help to prevent many diseases.
There are no vaccines that protect against serogroup B disease. There are two that cover serogroup C:
- One ('polysaccharide') vaccine covers serogroups A,C,W, and Y. It is useful for travellers to places such as Africa and Asia, and pilgrims to the Haj and it is sometimes used to control outbreaks. However, it cannot be given to children under the age of two, and it only provides protection for about three years.
- The other ('conjugate') vaccine can be given to all age groups, including babies from six weeks of age.
This vaccine effectively protects against serogroup C disease, and provides long lasting immunity.
If you think a person has symptoms that suggest meningitis or septicaemia, contact your doctor immediately, or go to the nearest hospital emergency department. Early diagnosis and treatment of sufferers and close contacts of a person who has the illness are vital. After you have seen a doctor, if your child or friend becomes more unwell or you continue to be worried, seek further help as the first signs of meningococcal disease are similar to those of influenza and many other common illnesses.
For more information about meningococcal disease or the vaccine, contact your local GP.
Article #8005
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