Meningitis (an infection of the membranes covering the brain and spinal cord)
Septicaemia (a blood infection)
There are many strains of meningococci, but the strains that cause almost all disease in Victoria are called serogroup B and serogroup C.
Most common in winter and spring
Cases can occur all year round and in all age groups, however, they are more common during winter and early spring. Children under five years of age and young adults aged 15 to 24 years are most commonly affected. In Victoria, about half of the cases are over 15 years of age.
A common bacteria that usually causes no harm
Meningococci live naturally in the back of the nose and throat in about 10 per cent of the population without causing illness. They are not found on the lips or teeth.
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 men and smokers.
In a small number of people, a particular strain of the bacteria manages to get through the lining of the throat, enter the blood stream and cause meningococcal disease.
The bacteria are difficult to spread
The meningococcal bacteria are difficult to spread. They are only passed from person to person by regular, close, prolonged household and intimate contact with secretions from the back of the nose and throat.
Research has shown that neither saliva nor salivary contact is important in the transmission of meningococci bacteria. In fact saliva has been shown to slow down the growth of meningococci.
Meningococcal disease is uncommon
Meningococci are only found in humans and cannot live for more than a few seconds outside the body. You cannot catch meningococcal germs from the environment or animals.
Most cases occur ‘out of the blue’ and are unrelated to any others. Outbreaks where more than one person is affected are rare.
Signs and symptoms – infants and young children
The signs and symptoms of meningococcal disease in infants and young children are:
Fever
Refusing to take feeds
Irritability, fretfulness
Grunting or moaning
Extreme tiredness or floppiness
Dislike of being handled
Vomiting
Diarrhoea
Turning away from light (photophobia)
Drowsiness
Convulsions or twitching
Rash of red-purple pinprick spots or larger bruises.
Signs and symptoms – older children and adults
The signs and symptoms of meningococcal disease in older children and adults are:
Fever
Headache
Neck stiffness
Discomfort when looking at bright lights (photophobia)
Vomiting
Diarrhoea
Aching or sore muscles
Painful or swollen joints
Difficulty walking
General malaise
Moaning, unintelligible speech
Drowsiness
Confusion
Collapse
Rash of red-purple pinprick spots or larger bruises.
Get further medical help if you are still worried
You know your family and friends better than anybody else. If somebody close to you has some of these signs and symptoms and you are worried that they are much sicker than usual, seek medical help immediately.
In the very early stages, meningococcal disease can appear to be like other, less serious illnesses. Your doctor may not immediately recognise this illness. Do not hesitate to seek medical help again – even if it’s only been an hour or two since you last went.
If the person seems to be sicker or has suddenly developed a rash or becomes drowsy – get medical help. Young adults should not be left alone if they suddenly develop a fever – they may become seriously ill very quickly.
Early antibiotic treatment is vital
If meningococcal disease is suspected, an antibiotic (usually penicillin) is given immediately, by injection. People with meningococcal disease are always admitted to hospital and may require admission to the Intensive Care Unit at first.
The sooner that antibiotic and other treatments begin, the less damage the disease will cause. However, this is a very serious infection, which can progress very rapidly despite the best treatment.
Close contacts are offered antibiotics
Most contacts, such as school and work friends do not need antibiotics.
Very close contacts of an affected person are offered a short course of clearance antibiotics. These people may be:
Members of the same household.
A girlfriend or boyfriend.
Anyone who has stayed overnight with the person who is unwell in the seven days before the illness.
Children in a day care or preschool centre where the affected person attended.
It is important to understand that these clearance antibiotics are very good at getting rid of meningococci bacteria from the throat, but they are not a treatment for meningococcal disease
Vaccines – how they work
There are no vaccines that protect against serogroup B disease. There are two different types that protect against serogroup C disease conjugate vaccines and polysaccharide vaccines.
Conjugate vaccines
There are different brands of conjugate meningococcal serogroup C vaccine available. The vaccines contain meningococcal serogroup C ‘sugars’ joined with an inactive protein of either diphtheria or tetanus toxoid and additives aluminium phosphate or hydroxide.
The ‘conjugate’ vaccines (Menjugate, Mengitec and NeisVac-C) can be given to all people of all ages, including babies from six weeks of age. These protect against serogroup C disease and provide long lasting immunity.
Since 2003, a single dose of conjugate meningococcal serogroup C vaccine has been offered to all children turning 12 months along, with their other routine immunisations due at that age. Children and adolescents aged one to 19, are eligible for free vaccines until 2006 through a staged national meningococcal program.
Polysaccharide vaccines
Polysaccharide vaccines (Menommune and Mencevax) cover several serogroups not usually seen in Australia. They are useful for people travelling to places such as Africa and Asia, and pilgrims to the Haj where these serogroups are more common. They are considered to be a travel vaccine and not recommended for general use. They cannot be given to children under the age of two, and only provide protection for about three years.
What to do if you suspect meningococcal disease
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 are vital.
Where to get help
Your doctor
Emergency Department of your local hospital
Things to remember
Meningococcal bacteria are only passed from person to person by regular close prolonged household and intimate contact with secretions from the back of the nose and throat.
You are the expert in your family’s health – if you are worried, seek immediate help.
It is important to go back to the doctor for more help if you are still worried.
Meningococcal C vaccine provides good protection from one strain of meningococcal disease.
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