Meningococcal disease – What is it? Why is it important? How to prevent illness?

Meningococcal disease is a serious bacterial infection caused by a bacteria named Neisseria Meningitidis, which has several different serogroups. Common groups include serogroups A, B, C, W, and Y. 

Meningitis Definition – An infection that causes inflammation of the fluid and membrane surrounding the brain and spinal cord.  

• Meningitis can be caused by several types of bacteria as well as several viruses.  
• Meningococcal disease is the leading cause of meningitis in older children and young adults. 

In addition to causing meningitis, it can also infect the blood stream, which is called (meningococcemia).  

Both illnesses need to be evaluated and treated quickly.  They can worsen from mild to severe very rapidly, sometimes within hours. 

Who Does it Affect: 

Annually about 1000 cases of meningococcal disease are reported in the US, with ages 15-21 being at the highest. 

Group C and Y specifically are most common in students entering college, living in dormitories, or military barracks.  

Symptoms: 

• Fever (often high) 
• Rash (flat, pink or red in color, at first which often turns to larger purple flat lesions) 
  • The rash is a very specific kind of rash that does not blanch (disappear briefly) when pressure is applied to it.   
• Nausea and vomiting 
• Muscle aches 
• Headache (often sudden and/or severe) 
• Sensitivity to light 
• Confusion 
• Stiff neck  

The combination of stiff neck, headache, and sensitivity to light together are particularly concerning.  

Treatment and Prevention: 

Meningococcal Disease needs to be treated with antibiotics as soon as possible.  However even with treatment up to 15% of infections can be fatal and up to 20% of survivors will have long term disabilities such as loss of hearing, limb amputation, kidney failure, chronic nervous system problems, or brain damage. 

Prevention through vaccination is the most important way to stop serious consequences from meningococcal disease. 

Primary Vaccination: 

The primary prevention of meningococcal disease is through the use of one of the Meningococcal serogroup A,C,W,Y (MenACWY) vaccines which are given in as a 2 dose series.  The American Academy of Pediatrics (AAP) and the Center for Disease Control (CDC) recommend giving the first dose between age 11-12 years old and the 2nd dose at age 16.  This emsures that all teenagers/adolescents are fully vaccinated prior to the most common age of infection and before starting college or military service where risk of infection, spread, and outbreaks increases.  The vaccine may also be recommended earlier, including as young as 2 months of age, in children at high risk for infection such as those with weakened immune systems or travel to countries with epidemics or high infection rates.  Since 2005, when the CDC began recommending pre-teens and adolescents receive a MenACWY vaccination, the rate of infection has decreased by over 90% in the United States.  

Meningococcal Serogroup B (MenB) and Vaccination.  

MenB is now the 3rd most common cause of meningococcal disease in the United States.  Serogroup B has historically been looked at differently than the other groups because it does not seem to have an increased risk of infection in dormitory type settings like the other groups discussed.  It does, however, cause the same symptoms, complications, and similar fatality rate (even when treated) as other strains of meningococcal disease.  Small outbreaks among college students have occurred from MenB, although less common than other strains of the bacteria.  For this reason, there is now a vaccine available specifically for prevention of MenB.  This vaccine is also given as a multiple shot series for children over 10 years old.  The ideal age to receive the vaccine. is 16-18 years old.  

The highest risk of MenB infection are children and adults with certain kinds of weakened immune systems: 

• Anyone exposed to a person or outbreak of MenB 
• Lack of a functional spleen (from sickle cell disease or removal) 
• Rare persistent compliment component deficiency 
• People who take medications called “compliment inhibitors” 
• People who work in labs with the bacteria 

The vaccine is recommended for these higher risk individuals but is also available for anyone age 16-23 to provide short term protection against MenB.  

Summary:  

• Meningococcal Disease is serious and can be fatal or cause long term disability or complications even if treated.  
• The best way to prevent illness and complications is routine vaccination with one of the available MenACWY vaccine series as a pre-teen and adolescent.  
• Vaccination against MenB although not routinely recommended for everyone at this time, is available for anyone age 16-23 years old for short term protection against Meningococcal Type B infection.  
• Speak with your child’s pediatrician about Meningococcal vaccines and prevention.