Meningococcal disease

Meningococcal disease is a bacterial infection that causes two very serious illnesses: meningitis (an infection of the membranes that cover the brain) and septicaemia (blood poisoning).

Summary

Meningococcal disease can cause death or permanent disability, such as deafness.

It can affect anyone – but it’s more common in children under the age of 5, teenagers, and young adults. Students in their first year of tertiary education living in hostel accommodation may also be at higher risk.

It’s important to know the signs and symptoms of meningococcal disease because it can develop very quickly (see the Symptoms tab). It can be treated with antibiotics, but early treatment is very important.

If you notice any of the symptoms of meningococcal disease or have any other concerns, contact your doctor without delay – or call Healthline free on 0800 611 116 at any hour of the day or night, even if you have already been seen by a health professional.

How is it spread?

Meningococcal bacteria are difficult to catch as they don’t live for very long outside of the body. They pass from one person to another through secretions from the nose or throat, for example by coughing or sneezing, but it usually needs to be quite close or prolonged contact. It is more likely to spread among people living in the same house or who are in very close contact with each other (including intimate kissing).

There are some factors that may put people at higher risk of developing meningococcal disease, for example living in overcrowded housing.

Basic steps like covering your nose or mouth when you sneeze or cough, and washing and drying your hands can help reduce the chance of spreading the bacteria.

Meningococcal bacteria

Meningococcal disease is caused by the bacterium Neisseria meningitidis. There are several different groups of meningococcal bacteria including groups A, B, C, Y and W135. These groups of bacteria can be further divided into specific strains.

  • Most cases in New Zealand are caused by group B (62% of confirmed cases in 2011).
  • The next most common is group C (38% of confirmed cases in 2011).
  • There have previously been limited outbreaks of meningococcal disease due to group A.
  • Cases of meningococcal disease caused by groups W135 and Y are rare in New Zealand.

Up to 15% of people carry the bacteria that cause meningococcal disease in their nose and throat without being sick. In some people, for reasons we don’t fully understand, these bacteria sometimes go on to cause disease, spreading through the bloodstream (causing blood poisoning) or to the brain (causing meningitis).

How common is it?

There are about 100 cases of meningococcal disease in New Zealand each year. It’s more common in winter and spring.

Between 2006 and 2010, there were between 5 and 8 deaths per year from meningococcal disease, and in 2011 there were 13 deaths.

Surveillance reports can be found on the ESR website.

You’re better to be safe than sorry: video

Mark and Lisa Gallagher’s daughter Letitia died of meningococcal disease in 2012. Since then, they’ve been working to raise awareness about the disease and the vaccines available that protect against it. Read more

‘In the space of 5 hours she’d gone from a headache and fever, to nothing they could do.’


Information for health professionals

  • Meningococcal disease – Access information that is targeted at health professionals – it gives case numbers, links to resources and so on.

Symptoms

Meningococcal disease can be difficult to diagnose because it can look like other illnesses, such as the flu.

Meningococcal disease has a range of general symptoms. These include:

  • a high fever
  • headache
  • sleepiness
  • joint and muscle pains.

There can also be some more specific symptoms, such as:

  • a stiff neck
  • dislike of bright lights
  • vomiting
  • crying
  • refusal to feed (in infants)
  • a rash consisting of reddish-purple pin-prick spots or bruises.

What to do

If you or anyone in your family has these symptoms, call your doctor straight away.

You can also call Healthline free on 0800 611 116 24 hours a day – even if you have already been seen by a health professional.

If you have seen a doctor and gone home, but are still concerned, don't hesitate to call your doctor again or seek further medical advice.

Treatment

Meningococcal disease can develop very quickly.

It’s important to be aware of the symptoms so you can get medical help straight away – whether it’s day or night.

Meningococcal disease can be treated with antibiotics – but early treatment is very important.

Prevention

Meningococcal disease can be spread from person-to-person through coughing and sneezing.

To help stop meningococcal bacteria from spreading:

  • cover your nose or mouth with your arm when you sneeze or cough
  • wash and dry your hands after using the toilet and before and after preparing food.

Immunisation

Several vaccines are available which protect against different groups of meningococcal disease – A, C, Y and W135. These vaccines aren’t free (except for some people whose spleens don’t work or who don’t have a spleen), but they’re available for private purchase through general practices if people want them.

Meningococcal immunisation may also be funded by local district health boards for public health purposes such as a disease outbreak.

Who should have the meningococcal vaccine

This vaccine is recommended and available free for:

  • people who have had or are having an operation to partly or completely remove the spleen (splenectomy)
  • children with a spleen doesn’t work properly (functional asplenia).

It’s also recommended, but not funded, for:

  • young people moving to hostels, especially in their first year
  • people with sickle cell anaemia
  • people with terminal complement deficiencies
  • people with HIV
  • military recruits
  • microbiologists and laboratory workers who could be exposed to meningococcal bacteria
  • travellers to regions where this disease is common – in particular people participating in the hajj, and people travelling to sub-Saharan Africa (the so-called ‘Meningitis Belt’).

Vaccines

There are a number of meningococcal vaccines which protect against different strains of the disease but none of them provide long-term protection. The vaccines listed below tend to last around three-to-five years.

Even if you have been immunised in the past you may still not be protected against the disease. It’s important therefore that you’re aware of the signs and symptoms of meningococcal disease, and seek medical advice quickly if you’re concerned.

There are two main types of meningococcal vaccine available in New Zealand:

  • ‘Polysaccharide’ meningococcal vaccines, which protect against 4 groups – A, C, Y, and W135. These are available for use over the age of 2.
  • ‘Conjugate’ meningococcal vaccines – 1 vaccine which protects against A, C, Y, and W135 meningococcal bacteria and 2 vaccines which protect against group C only. The ages at which these vaccines can be given varies depending on the vaccine used.

Some details on these vaccines are given below.

Meningococcal A, C, Y and W135 polysaccharide vaccines

Polysaccharide meningococcal vaccines are available which protect against groups A, C, Y and W135 meningococcal bacteria. Children over 2 years old and adults can have these vaccines.

  • You need 1 dose of the vaccine to be protected.
  • Protection lasts approximately 3 years (sometimes less in young children) and may last longer.

Meningococcal A, C, Y and W135 polysaccharide vaccines licensed in New Zealand are:

Meningococcal A, C, Y and W135 conjugate vaccine

A conjugate meningococcal vaccine which protects against meningococcal A, C, Y and W135 is also available. People aged 2–55 years can have this vaccine.

  • You will need 1 dose of the vaccine to be protected and a booster after 5 years for longer-term immunity.

Meningococcal A, C, Y and W135 conjugate vaccines licensed in New Zealand are:

Meningococcal C conjugate vaccine

Separate conjugate meningococcal C vaccines, which protect against group C meningococcal bacteria alone, are also available. These vaccines can be used for children under 2.

  • Babies under 12 months need 3 doses to be protected.
  • Children over 12 months and adults need 1 dose to be protected.

The meningococcal C vaccine lasts 2–3 years in children under 6 and around 5 years in children over 6 and adults.

Meningococcal C vaccines licensed in New Zealand are:

Possible reactions to meningococcal vaccine

Common side effects of vaccine

  • Soreness/pain, redness and/or swelling around the injection site
  • Mild fever
  • Decreased appetite, nausea, vomiting and/or diarrhoea
  • Irritability
  • Headache
  • Fatigue, malaise, drowsiness

Uncommon side effects vaccine

  • Dizziness

Rare/very rare side effects of vaccine

  • Anaphylaxis (severe allergic reaction)
  • Urticaria (allergic skin reaction)

Serious reactions are rare.

For more advice on meningococcal vaccines and their availability, talk to your doctor or practice nurse or call the Immunisation Advisory Centre free helpline 0800 IMMUNE (0800 466 863).

Meningococcal B vaccine

There are currently no vaccines available in New Zealand that protect against meningococcal B.

The previously available MeNZB™ vaccine was developed to curb an epidemic of a particular strain of group B meningococcal disease. This vaccine was offered to babies, children and teenagers from 2004–2008.

It’s important to note that this vaccine only protected against the strain causing the epidemic – not any other type or strain of meningococcal disease.

The MeNZB™ vaccine is no longer on National Immunisation Schedule. The rates of disease caused by this particular strain fell to a level where experts advised that offering it routinely was no longer necessary.

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