About Meningococcal Disease
Neisseria meningitidis (meningococcus) is a bacterium that can cause serious illness and, in some cases, death. In the United States, it has become the leading cause of bacterial meningitis in children and adolescents, and the second most common cause of bacterial meningitis in adults. Meningococcus can also cause bloodstream infections. Meningococcal infection is most common during the winter months and can be easily confused with the flu. In some people, meningococcus can live in the nose and throat without causing illness. Meningococcus is usually spread to others by sharing secretions (saliva) from the upper respiratory system (coughing, kissing, etc.) but is not as contagious as the common cold or the flu. Symptoms of meningococcal infection usually come on suddenly and progress quickly to serious illness. If left untreated, the infection can be life threatening. People at risk for meningococcal infections include infants, teens, young adults, older adults, people with conditions that weaken the immune system and people who live in close quarters such as college students and military personnel. The most important way for people to protect themselves from meningococcal infection is to get vaccinated.
Symptoms of meningococcal infection can vary and may include a rapid onset of fever, headache, neck stiffness, sensitivity to light, nausea, vomiting and confusion. Recognizing illness can be more difficult in infants and young children. Infants may seem irritable or slow, feed poorly or the soft spot of their skull may bulge. Other symptoms of bloodstream infection can include cold hands and feet, rapid breathing, severe body aches and a purple spotted rash. Illness from meningococcus is usually diagnosed by blood tests and a spinal tap. Even when treated, 10-15 percent of meningococcal infections result in death, and people who do survive often have brain damage, deafness or other serious problems. It is important for to be aware of the risks of meningococcal disease for prevention and treatment strategies. It is important to know that if you or someone you know has a sudden onset of severe headache, fever, or any of the other symptoms mentioned, you should get emergency medical care.
Meningococcal disease is caused by infection with the N. meningitidis bacterium.
- Meningococcal disease is an infection that most commonly affects the tissues of the brain and spinal cord, the bloodstream, and less often can cause pneumonia.
- Meningococcus can live in the nose and throat without making someone sick.
- Meningococcus is spread through the exchange of saliva (kissing) or respiratory droplets when an infected person coughs.
- The bacterium enters the body through the nose or mouth and infects the tissues of the brain and spinal cord or bloodstream leading to inflammation and damage.
Meningococcus Risk Factors: Meningococcus is not as highly contagious as the flu or the common cold, but it is spread through close contact. Risk factors for developing meningococcal disease include
- Age: Infants younger than one year, adolescents, young adults and the elderly are at highest risk.
- Close contact with infected individuals: Family members and healthcare workers are at highest risk.
- Living conditions: Crowded living environments, such as college dorms or military barracks can facilitate the spread of meningococcus.
- Immune system deficiencies: People with weakened immune systems such as those with HIV, sickle cell disease or people taking medications that suppress the immune system (chemotherapy for cancer) are at increased risk.
It is important to note that risk factors may increase a person’s chance of getting a meningococcal infection, but that does not mean that everyone with risk factors will get meningococcal disease. Taking preventive measures, such as practicing good hygiene, avoiding close contact with sick individuals and getting vaccinated can help reduce the risk.
The most common early symptoms of meningococcal disease include:
- Fever
- Headache
- Stiff neck
- Sore throat
- Stuffy or runny nose
- Nausea
- Fatigue
As the infection progresses or becomes more severe, the following symptoms may occur:
- Vomiting
- Severe body aches
- Confusion
- Purple rash
- Cold hands and feet
- Rapid, shallow breathing
Babies may not always have typical symptoms. In infants less than 6 months old, symptoms may include:
- Fussiness or irritability
- Sleepiness or lethargy
- Decreased feeding
- Changes in breathing patterns (for example, rapid breathing)
If you or someone you know experience any severe symptoms or are at high risk for meningococcal disease, it's essential to seek emergency medical attention. Your healthcare provider can provide a proper diagnosis and recommend appropriate treatment options.
To diagnose meningococcal disease, the following examinations, tests, and procedures are commonly performed:
- Medical history: The healthcare professional will ask about your symptoms and medical history. They will want to know about your medical conditions and medications.
- Physical exam: The healthcare professional will perform a thorough physical exam to check for rashes, neck stiffness or other signs of illness.
Based on initial findings, severity of symptoms, and individual factors, additional examinations, tests or procedures may be performed, including:
- Chest X-ray: This imaging test can help identify complications such as pneumonia.
- Blood tests: These can include a complete blood count (CBC) to assess white blood cell count and inflammation markers, as well as respiratory viral panel testing to detect other respiratory viruses that may be present. Blood cultures may be obtained to see if bacteria are growing in the bloodstream.
- Lumbar puncture: A spinal tap is a procedure that uses a small needle to take a small sample of the fluid that surrounds the spinal cord. The fluid is tested for signs of infection.
- Imaging: Brain imaging such as CT or MRI may be performed to look for signs of inflammation.
It's important to note that other examinations, tests, and procedures may performed based upon the individual situation.
Prevention
The best treatment for meningococcal disease is preventing infection. In addition to avoiding exposure to people who may be infected with meningococcus, there are now meningococcal vaccines widely available. The Centers for Disease Control and Prevention (CDC) guidance recommends the following groups of people get one of the latest meningococcal vaccines as the best way to prevent infection:
- Children: Children 2 months -10 years who are at increased risk
- Preteens and teens: All children should get the vaccine at the age of 11-12 as well as a booster at age 16.
- Adults: Adults over the age of 18 who are at increased risk due to health conditions that weaken the immune system, are traveling to areas of the world where the disease is common (areas of Africa) or work with the bacteria in a laboratory.
Currently, the number of meningococcal vaccine shots required depend on the age and risk factors of the individual. More research is needed to know exactly how long the meningococcal vaccines last and how much protection they provide.
There are currently three types of meningococcal vaccines available in the US. They protect against one or more serogroups (strains) of meningococcus bacteria.
- MenACWY vaccines (also called meningococcal conjugate vaccines)
- These include Menveo and MenQuadfi
- MenB vaccines (also called serogroup B meningococcal vaccines)
- These include Bexsero and Trumemba
- MenABCWY vaccine (also called pentavalent vaccine)
- This includes Penbraya
It is important to discuss prevention options with a healthcare professional who can provide guidance for the choice of vaccine and number of vaccines needed for an individual situation.
Treatment
Meningitis and bloodstream infection due to meningococcus are medical emergencies. Early treatment is the most important way to prevent the complications of the infection. Recommended treatments include:
- Antibiotics: Early treatment with intravenous antibiotics is extremely important.
- Steroids: IV steroids are often given in the treatment of meningitis to help reduce inflammation of the brain.
- Protein C concentrate: Although not approved by the US Food and Drug Administration, this protein may help improve the bleeding problems that can occur with life threatening meningococcal infections.
- Supportive therapies may be needed, including
- Oxygen therapy
- Intravenous hydration
- Medications to help blood pressure
Early detection, prevention strategies (such as vaccination) and supportive care play crucial roles in managing meningococcal disease. Always consult with your healthcare professional for personalized advice regarding treatment options.