Meningococcal Disease

What is Meningoccal disease?
Meningococcal disease can refer to any illness that is caused by the type of bacteria called Neisseria meningitidis, also known as meningococcus [muh-ning-goh-KOK-us]. These illnesses are often severe and include infections of the lining of the brain and spinal cord (meningitis) and bloodstream infections (bacteremia or septicemia).

Meningococcus bacteria are spread through the exchange of respiratory and throat secretions like spit (e.g., by living in close quarters, kissing). Meningococcal disease can be treated with antibiotics, but quick medical attention is extremely important. Keeping up to date with recommended vaccines is the best defense against meningococcal disease.

What is meningococcal meningitis?
Meningitis is an inflammation of the covering of the brain and spinal cord. Meningitis can be caused by many different viruses and bacteria. Meningococcal meningitis is a type of meningitis caused by the bacterium Neisseria meningitidis. It is rare in countries like the United States where meningococcal vaccine is part of the routine vaccination schedule for adolescents.

What causes meningococcal disease?
There are several different types of Neisseria meningitidis bacteria, which can cause meningitis. Four of the five most common types of these bacteria are preventable by vaccines.

Who is most likely to get meningococcal disease?

Certain groups are at increased risk for meningococcal disease. Risk factors include:

• Age: Health care providers more commonly diagnose meningococcal disease in infants, teens and young adults, and older adults.
• Group Settings:The risk for meningococcal disease in college students, particularly for those living in close quarters, is slightly higher than the risk in other teens and young adults who are not attending college.
• Certain Medical Conditions: Certain medical conditions and medications put people at increased risk for meningococcal disease, such as people without a spleen, with blood disorders, or living with HIV.
• Travel: Travelers to countries where meningococcal disease is common may be at risk.

How is meningococcal disease spread?

This is a serious disease caused by bacteria called Neisseria meningitidis. Fortunately, these bacteria are not as contagious as germs that cause the common cold or flu. People do not catch the bacteria through casual contact or by breathing air where someone with meningococcal disease has been. It requires close contact over a period of time, or direct contact such as kissing or sharing drinks.

Early symptoms of the disease include fever, headache, stiff neck, nausea, vomiting, light sensitivity, confusion, and rash. Anyone who has been exposed or develops symptoms should be evaluated by a health care provider immediately. This is a rare but potentially devastating disease

What are the symptoms of meningococcal disease?

Meningococcal disease can lead to meningitis (infection and swelling of the lining of the brain and spinal cord) and septicemia (infection of the bloodstream).

Anyone who has been exposed or develops symptoms should be evaluated by a health care provider immediately. This is a rare but potentially devastating disease.

Meningococcal Meningitis

Symptoms can first appear as a flu-like illness and rapidly worsen. Symptoms include:

• Fever, headache, and stiff neck.
• Nausea, vomiting, light sensitivity, confusion, and rash.

Symptoms can differ in infants and may include:

• Slow or inactivity, irritability, vomiting, poor feeding, or a bulging soft spot on their head.

Meningococcal Septicemia (Meningococcemia) Symptoms may include:

• Fever and chills, fatigue, vomiting, cold hands and feet, rapid breathing, and diarrhea.
• Severe aches or pain in the muscles, joints, chest, or abdomen. In the later stages, a dark purple rash.

How is meningococcal disease diagnosed?
If meningococcal disease is suspected, samples of blood or cerebrospinal fluid (surrounding the spinal cord) are collected and sent to the laboratory for testing.

How is meningococcal disease treated?
Health care providers prescribe antibiotics to treat meningococcal disease. People with meningococcal disease are no longer able to spread it to others after taking an appropriate antibiotic for 24 hours. People may also need advanced medical care, which could include treatment in an intensive care unit.

What steps can I take to lower my chances of becoming infected or infecting others?
Keeping up to date with recommended immunizations is the best defense against meningococcal disease. Maintaining healthy habits, like getting plenty of rest and not coming into close contact with people who are sick, can also help.

Meningococcal vaccines protect against most types of meningococcal disease, although they do not prevent all cases. There are two kinds of vaccines that protect against meningococcal disease available in the U.S., meningococcal polysaccharide vaccine and meningococcal conjugate vaccine. The most effective way to prevent meningococcal disease is for children and persons in high risk groups to receive the meningococcal vaccine.

Who needs to be vaccinated?
Routine vaccination with a meningococcal disease vaccine is recommended for adolescents aged 11 or 12 years, with a booster dose at age 16 years. The following adult populations are at risk for meningococcal disease: college freshmen living in dormitories who were not previously immunized; microbiologists who are routinely exposed to N. meningitidis; military recruits; persons who travel to or reside in countries in which N. meningitidis is hyperendemic or epidemic; persons who have terminal complement component deficiencies; and persons who have functional or anatomic asplenia. Adults who have human immunodeficiency virus (HIV) type 1 infection are at increased risk for meningococcal infection, and vaccination should be considered in this group as well.

At what age should preteen or teens get vaccinated?
All 11-12 years olds should be vaccinated with meningococcal conjugate vaccine (Menactra® or Menveo®). A booster dose should be given at age 16 years. For adolescents who receive the first dose at age 13 through 15 years, a one-time booster dose should be administered, preferably at age 16 through 18 years, before the peak in increased risk. Adolescents who receive their first dose of meningococcal vaccine at or after age 16 years do not need a booster dose.

What if my child is about to start college and got their first dose more than 5 years ago?
For the best protection, we recommend that your child receives a booster dose. Meningococcal vaccination is required to attend many colleges. The Advisory Committee on Immunization Practices (ACIP) suggests that your child receive the vaccine less than 5 years before starting school.

How soon after the first dose of vaccine can the booster dose be given?
Adolescents age 16 through 18 years can get the booster dose at any time. The minimum interval between doses is 8 weeks.

Are there safety concerns with getting a booster dose?
Available data suggests that the booster dose is very safe, but vaccine safety will continue to be monitored.

As an adult, do I need it?
You should get meningococcal vaccine if:

• You are a first-year college student living in a residence hall
• You are a military recruit
• You have a damaged spleen or your spleen has been removed
• You have terminal complement deficiency
• You are a microbiologist who is routinely exposed to Neisseria meningitidis (the causal pathogen)
• You are traveling or residing in countries in which the disease is common.

Does my infant or child need this vaccine?
Meningococcal conjugate vaccine is recommended for certain children at increased risk from ages 2 months through 10 years.

Is vaccine recommended during institutional outbreaks?
During outbreaks of meningococcal disease in specific settings, such as schools, vaccination may be recommended for persons aged 2 months and older at increased risk of disease. Household members and other close contacts of a person with meningococcal disease may be given antibiotics to reduce their chances of developing illness.

If you have any questions, please contact your health care provider.

For more information from the Centers for Disease Control and Prevention (CDC).