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).
Meningococcal disease (including meningitis)
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 student 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, during close or prolonged contact, for example:
- by coughing or sneezing (by droplet spread)
- by kissing
- by sharing eating or drinking utensils, toothbrushes, pacifiers.
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 that can cause illness.
Who is most at risk?
Anyone can potentially get meningococcal disease, but, it is more common in:
- babies and young children
- teenagers and young adults
- people with a weak immune system – for example those having chemotherapy treatment or have HIV
- close contacts of meningococcal disease cases (eg, same household)
- those having other respiratory infections (eg, flu)
- people living in shared accommodation such as halls of residence (university), boarding school and hostels
- those living in overcrowded housing
- those exposed to tobacco smoke.
It is possible to get meningitis more than once.
Meningococcal disease is caused by the bacterium Neisseria meningitidis. There are several different groups of meningococcal bacteria including groups A, B, C, Y and W (previously called W135). These groups of bacteria can be further divided into specific strains.
- Most cases in New Zealand are caused by group B.
- The next most common group was group C.
- Since 2017 there has been an increasing number cases of meningococcal disease caused by groups W and Y, and group W is now the second most common group, followed by group Y.
- There have previously been limited outbreaks of meningococcal disease due to group A.
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?
Between 2013 and 2017, there have been between 26 and 70 cases of, and between 2 and 9 deaths from meningococcal disease each year in New Zealand, with an overall upward trend since 2014. The disease is more common in winter and spring.
Surveillance reports can be found on the ESR website (please refer to the sections on meningococcal disease reports and annual surveillance summary).
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.’
Title: Mark & Lisa Gallagher – Daughter Letitia died in 2012 from meningococcal disease
[The video is an interview with Mark and Lisa, although Mark does most of the talking. It includes family photos of their daughter Letitia, in her late teens.]
Mark: It started on a Sunday night. Our daughter came for dinner, as she usually does on a Sunday night, with her boyfriend but she wasn’t very well, she had a bit of a temperature so she didn’t eat anything. She then went to bed that night with a bit of a headache, so she took some Panadol.
She woke up at about 3 in the morning with a very very painful head. Thankfully her boyfriend was there and he rang an ambulance straight away and they shot her straight through to Palmerston A and E. We both got there we were pretty shocked as to what we saw, it was pretty horrific thing to see.
We were told that ICU would be closed for a couple of hours while the doctors do their rounds. We were asked to just go away and have a coffee and freshen up then come back in an hour or so. We only got down as far as the car park. The boyfriend had stayed in the waiting room, he text us and said, ‘Look, you better come back, there’s been a development.’
We came back and they took us into another room and said, ‘Look, she’s pretty bad, there’s nothing they can do for her, she’s dying.’
And that was at 8:30 am. So in the space of 5 hours, she’d gone from a headache and fever to nothing they can do. The only real symptoms was the headaches, the temperature, the vomiting and that was pretty much it.
I mean OK, they have a lot of symptoms with meningitis, not all of them show straight away, that’s the thing we found. So you’re better to be safe than sorry.
We didn’t know, we had no idea. It’s not until now that we realise that, ok Men (Meningococcal) C, you can actually get a separate vaccine to that, Men B one to the Men A one, so there’s lots of different strands of it. So unfortunately, yeah she wasn’t immunised against Men C.
Yeah, we’ve been very active. We’ve been down to Parliament for the launch of the new immunisation campaign and just the awareness of it all and getting the awareness of out there to, you know, make people immunised and tell them about it and get them to say look, ya know, start talking about it. And that’s what it’s all about, it’s a matter of getting your people to be aware of it, get the immunisation out there and get their kids vaccinated.
So yeah we’ve done a bit, we’re doing our best.
Lisa: And we still will.
Mark: And we will, we definitely will. Yeah we’ve got a lot more to do yet.
Lisa: Keep going.
Mark: Our daughter would be kicking our butts if we didn’t!
Meningococcal disease can be difficult to diagnose because it can look like other illnesses, such as the flu.
Symptoms of meningitis can develop suddenly and include:
- a high fever
- joint and muscle pains.
There can also be some more specific symptoms, such as:
- a stiff neck
- dislike of bright lights
- 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 or dial 111.
- Say what the symptoms are.
- 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. Don’t be put off. Insist on immediate action.
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.
Meningococcal disease bacteria can be spread from person-to-person through secretions and respiratory droplets.
- cover your nose or mouth when you sneeze or cough and wash and dry your hands
- avoid sharing eating or drinking utensils, toothbrushes, pacifiers.
There are vaccines available to provide protection against the five different groups of meningococcal disease – A, C, W, Y and B. Two different meningococcal vaccines – one which protects against the disease from group C (Neisvac-C), and the other which protects against groups A, C, W and Y (Menactra) – are funded for some people (see below).
There are other vaccines available, including one which protects against group B (Bexsero). These vaccines aren’t funded, but they’re available for private purchase through general practices if people want them.
Local District Health Boards may also fund meningococcal immunisation for public health purposes such as a disease outbreak.
From 1 December 2019, people aged 13-25 years living in boarding school hostels, tertiary education halls of residence, military barracks, or prisons, can receive a single dose of meningococcal ACWY vaccine (Menactra) free of charge. For more details see the Immunisation Advisory Centre website.
Who should have the meningococcal vaccine
Some meningococcal vaccines are recommended and available free for individuals:
- who are adolescents or young adults aged 13–25 years in a close-living situation, such as a boarding school hostel, university hall of residence, military barrack or prison
- who have had or are having an operation to partly or completely remove the spleen (splenectomy)
- with a spleen doesn’t work properly (functional asplenia)
- who are HIV positive
- who have an inherited or acquired complement deficiency
- who are pre- or post-solid organ transplantation
- who are bone marrow transplant patients
- following immunosuppression for longer than 28 days
- who are close contacts of a meningococcal disease case.
They are also recommended, but not funded, for:
- 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’).
Check with your health professional whether they have the vaccine in stock before making an appointment to get vaccinated against meningococcal disease.
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 3–5 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:
- ‘Conjugate’ meningococcal vaccines – two vaccines which protect against A, C, Y, and W135 meningococcal bacteria and a vaccine which protects against group C only. The ages at which these vaccines can be given varies depending on the vaccine used.
- Meningococcal B vaccine, a recombinant vaccine for use in babies through to adults.
Some details on these vaccines are given below.
Meningococcal A, C, Y and W135 conjugate vaccine
Meningococcal A, C, Y and W135 conjugate vaccines approved in New Zealand are:
- Menactra (PDF, 113 KB), approved for those aged 9 months to 55 years. This vaccine is publicly funded for some at-risk groups as noted above.
- Nimenrix (PDF, 431 KB), approved for those aged 12 months to 55 years.
Meningococcal C conjugate vaccine
A separate conjugate meningococcal C vaccine, which protects against group C meningococcal bacteria alone, is also available. This vaccine can be used for children under two years of age, and is publicly funded for some at-risk groups as noted above.
- 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 two to three years in children under six years of age and around five years in adults and children over six years of age.
Meningococcal B vaccine
In 2018, the vaccine Bexsero was approved for use in New Zealand, following approval overseas since 2013. Babies younger than six months of age need three doses to be fully protected, while older babies, children, adolescents and adults need two doses.
Bexsero is different to the MeNZB vaccine used in New Zealand from 2004-2008.
Possible reactions to meningococcal vaccines
Common side effects of vaccines
- Soreness/pain, redness and/or swelling around the injection site
- Mild fever - paracetamol is recommended for use with Bexsero to reduce the risk of high fever and injection site pain
- Decreased appetite, nausea, vomiting and/or diarrhoea
- Fatigue, malaise, drowsiness
Uncommon side effects vaccine
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 free helpline 0800 IMMUNE (0800 466 863).