Meningococcal disease is caused by the bacterium Neisseria meningitidis. It causes a range of serious, life-threatening diseases including septicaemia (blood poisoning) and meningitis. It can affect all age groups, but the rates of disease are highest in children under five years of age, with the peak incidence in those under one year of age. There is a second peak in incidence in young people aged 15 to 19 years of age.
What are the symptoms?
- is the inflammation of the outer covering of the brain and spinal cord.
- is notoriously difficult to spot in the early stages.
- Early symptoms are usually fever, vomiting, headache and feeling unwell, just like in many mild illnesses.
- Other symptoms include high-pitched screaming in babies, being difficult to wake, and tense or bulging soft spot on head.
- The disease progresses very quickly, and can kill in a matter of hours.
- is a serious form of blood poisoning
- produces a rash in most cases, which is typically non-blanching (but not always, especially in the early stages)
- may cause joint and limb pain
- causes shock.
Overall, 1 in 20 cases of meningococcal disease result in death; death rates are higher for teenagers and young adults. 1 in 5 survivors have permanent effects such as skin scars, limb amputation(s), hearing loss, seizures and brain damage.
How is it passed on?
Meningococcal disease is spread by prolonged, close contact with an infected person. Between 5% and 11% of adults carry the bacteria harmlessly in their throats without any signs or symptoms of the disease. In teenagers this rate rises to 25%, but the carriage rate is low in infants and young children. The number of cases of meningococcal disease peaks in the winter each year.
It is not fully understood why disease develops in some individuals but not in others. Researchers have identified risk factors including smoking, previous infection with influenza type A, and living in ‘closed’ or ‘semi-closed’ communities, such as university halls of residence or military barracks.
What protection is available?
There are thirteen different types of the bacterium. Six of these - types A, B, C, W, X and Y - cause most of the disease cases worldwide. The most common types in the UK are B, C, W and Y. The only type currently protected against in the UK schedule is type C (although a vaccine against type B will be introduced in 2015). Children are protected against type C through the MenC vaccine, the Hib-MenC Booster vaccine and the teenage MenC booster vaccine. From 2014-2018 MenC vaccination is also being offered to all student freshers (i.e. those born between 1995 and 1999 who are starting university between 2014 and 2018). See our blog article on the MenC booster for freshers.
A vaccine against type B infections was licensed for use in Europe in 2013. In March 2014 it was recommended that this vaccine should be introduced into the UK routine schedule (see our blog post from March 2014), and in March 2015 the government announced that the vaccine would be introduced sometime in 2015. See more information on the new MenB vaccine.
Since 2009, cases of MenW disease have been on the increase in the UK. In March 2015 it was recommended that all 14-18 year olds in the UK should be offered the MenACWY vaccine to protect them against disease caused by MenW (see our blog post from March 2015).
The MenACWY vaccine is recommended for travellers to parts of the world which are high risk for meningococcal disease (including parts of Africa and Saudi Arabia). All visitors to the Hajj and Umrah pilgrimages in Saudi Arabia need proof that they have been vaccinated against type A, C, W and Y meningococcal disease. Travel vaccines are not provided free of charge.
Meningococcal Septicaemia (MenB) - Charlotte's story
Five year old Charlotte Nott developed septicaemia through type B meningococcal disease infection. Her mother, Jenny Daniels, talks about the devastating impact on Charlotte and the rest of her family, and the prospect of a new MenB vaccine that will help to prevent other people going through the same experience in the future. See the Charlotte's Appeal website for more information about Charlotte.
Meningococcal disease - Ashley Lee's story
US student Ashley Lee caught meningococcal disease shortly after starting college. She had not had the vaccine which could have prevented it. Grateful thanks to the US National Meningitis Association and Shot by Shot for permission to use this film.
Tom - a student's meningitis story
Tom Newman developed meningococcal disease at university. His life was saved by a friend who recognised the symptoms of meningitis. (Film made by Meningitis Now.)
Meningococcal disease is most often seen in infants and young children.
Following introduction of the MenC vaccine in 1999, the number of cases caused by the type C of the bacterium fell by over 90% in vaccinated groups, and by around 66% in non-vaccinated groups due to herd immunity (see graph below). Type C infections have caused only 2 deaths in children and young people under 20 in the last 5 years, compared to 78 deaths in the single year before the vaccine was introduced.
Following the success of the MenC vaccination program, type B infections account for 90% of the cases of meningococcal disease. A total of around 750 people in the UK, the majority babies and children, were infected by MenB in 2011, and around 50 of these died. Oxford Vaccine Group (OVG) has worked on the development of MenB vaccines and run trials into their effectiveness. OVG has also run studies looking at the effectiveness of a vaccine which gives protection against strains A,C,W and Y.
Source: Public Health England
Published by Owain John
Medical content reviewed by Professor Andrew Pollard
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Last updated 30/01/2015