Meningococcal Disease

What is meningococcal disease?

Meningococcal disease is caused by the bacterium Neisseria meningitidis. Different kinds of infections can be caused by this bacterium, including meningitis and meningococcemia. Meningococcemia is a blood infection. Meningitis, the most common meningococcal disease, is an infection of the coverings of the brain and spinal column. Meningitis can also be caused by other bacteria and viruses.

What are the signs and symptoms?

Common symptoms of meningitis in anyone over the age of two include:

These symptoms can develop over several hours, or they may take one to two days.

Other symptoms may include:

In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures. Common symptoms of meningococcemia include abrupt onset of fever, chills, and rash. Symptoms of both meningitis and meningococcemia may occur one to 10 days after exposure, but usually appear within three to four days.

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Who is at risk for getting meningococcal disease?

Meningococcal disease occurs most frequently in children under age five. It can also occur in older children and adults. Infants routinely receive a vaccine to prevent one type of meningitis caused by a different bacterium, Haemophilus influenzae, however, this vaccine does not prevent meningococcal disease.

How is meningococcal disease spread?

Some people “carry” the bacterium that causes meningococcal disease, Neisseria meningitidis, in the back of their nose and throat without ever becoming ill. Most of these people do not even know that they have it. This bacterium is spread from person to person through the exchange of respiratory and throat secretions. For example, it may be spread through kissing or coughing.

Meningococcal disease is not as contagious as the common cold or the flu, and it is not spread by casual contact or by simply breathing the air where a person with meningococcal disease has been. People in the same household or child care center, or anyone with direct contact with a patient’s oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of acquiringinfection. Classmates and co-workers are NOT considered to be at high risk for getting meningococcal disease unless they have some special close contact with an ill person as described above.

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How is meningococcal disease diagnosed and treated?

Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor immediately. Growing bacteria from a sample of spinal fluid or blood usually makes the diagnosis of meningitis or meningococcemia. Meningococcal disease is very serious and must be treated immediately with hospitalization and intravenous (IV) antibiotics. It is important, however, that treatment be started early in the course of the disease.

What measures are taken to prevent the spread of disease?

When a diagnosis is made, the doctor notifies the Vermont Department of Health. The doctor and the Health Department work with the patient and the patient’s family to identify close contacts who may have been exposed to the disease. Close contacts are referred to their own doctors to receive antibiotics that will kill the bacteria if the individual was unknowingly infected. Killing the bacteria will help prevent the person from becoming ill or passing the disease on to others.

People who are not close contacts of the patient do not need to receive antibiotics. Anyone with questions about whether they should receive treatment should talk to their own doctor.

There are four vaccines licensed in the US for the prevention of Neisseria meningitidis.

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of all 11-12 year olds with meningococcal conjugate vaccine (MCV4), with a booster dose at age 16 years. Even though the disease is not very common, vaccination can prevent as many adolescents as possible from getting it. Some schools, colleges, and universities have policies requiring vaccination against meningococcal disease as a condition of enrollment for either incoming first-year students living in residence halls or all incoming first-year students

ACIP also recommends routine vaccination for persons at increased risk for meningococcal disease (i.e., persons who have persistent complement component deficiencies, persons who have anatomic or functional asplenia, microbiologists who routinely are exposed to isolates of N. meningitidis, military recruits, and persons who travel to or reside in areas in which meningococcal disease is hyperendemic or epidemic). The vaccine product, number of doses, and booster dose recommendations are based on age and risk factor.

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How easily is this disease spread?

Meningococcal disease is uncommon and it is very unusual for more than one case to occur in a community. It is NOT a highly infectious disease. Rarely, a community may experience an outbreak of a few cases. If more than one case is identified in a small area, the Health Department studies the situation carefully and may suggest other special prevention measures, including vaccination.

After a case has been identified in the community, the general public may be advised to learn the symptoms of meningococcal disease. For the next few weeks, they can watch their family members for signs of illness and check promptly with their doctor if anyone in their household develops any of the symptoms.

For further information about meningococcal disease or vaccine, please contact your health care provider or the Vermont Department of Health.

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