MENINGOCOCCAL INFECTION
What is Meningocococcal Disease?
• Meningococcal infection can kill within hours[1] and is the most common cause of bacterial meningitis in the UK and Ireland affecting around 2000 people a year[2].
• Meningococcal bacteria (Neisseria meningitidis) can cause meningitis or septicaemia, or a combination of these diseases. Meningitis is the inflammation of the lining around the brain and spinal cord. Septicaemia is the blood poisoning form of the disease[2].
• Five of the thirteen identified types or serogroups (A, B, C, W-135, and Y) cause the majority of Meningococcal disease worldwide, but the distribution of serogroups varies widely from region to region and country to country[3].
• In the UK the most common strains are Men B and C, however, since the introduction of a Men C vaccine, 90% of cases are caused by Men B infection[4].
What are the signs and symptoms?
• The symptoms of Meningococcal meningitis may include fever, vomiting, severe headache, dislike of bright lights, stiff neck and lethargy. These symptoms do not appear in any particular order and some may not appear at all[5].
• Meningococcal septicaemia is blood poisoning caused when bacteria enter the bloodstream and multiply uncontrollably. It presents as a characteristic non-blanching, haemorrhagic rash[2].
Who is at risk?
• Meningococcal infection is spread between individuals by coughing, sneezing
and intimate kissing.[4].
• Meningococcal disease can affect anyone of any age, but over half of cases occur in children aged less than five years, with babies at the highest risk because their body’s defences are not fully developed[2].
• There is also an increased risk of infection in closed communities where transmission is enhanced due to close proximity. Examples of these include:
o College/Universities (especially Halls of Residence)
o Households
o Nurseries and Schools
Treatment and prevention of Meningococcal Disease
• Meningococcal meningitis and septicaemia need immediate treatment with antibiotics[4].
• People who have come into close contact with sufferers will also require antibiotics to reduce the risk of passing on bacteria to others[4].
• There are two types of vaccines used in the prevention of Meningococcal disease; Polysaccharides and Conjugates. Conjugation is a process which boosts the immune response, creating immune memory and increasing vaccine immunogencity[6].
• Conjugate vaccines have addressed the limitations of early vaccine technology, such as hyporesponsiveness, and now help provide protection against Meningococcal disease in all ages. Conjugation has also been demonstrated to reduce carriage and help in establishing herd / population immunity[6].
• The UK was the first country in the world to introduce a conjugate vaccine for immunisation against Group C disease for everyone over the age of 2 months.
• The UK national immunisation programme recommends vaccination against Meningococcal Group C disease for babies at months 3 and 4. An additional jab which protects against Meningococcal Group C disease and against the bacteria Haemophilus influenzae b (Hib) is given to babies at 12-13 months of age[7].
• Since the Meningitis C vaccine was introduced in 1999, deaths from the disease have fallen from as many as 79 to an average of less than one death a year[8].
• Cases of bacterial meningitis in children are at a record low. Cases of Men C in children have reduced by 95 per cent since the introduction of the Meningococcal C conjugate vaccine in 1999 - and over 500 deaths have been prevented[9].
• A vaccine against Groups A,C,W & Y is available and recommended for travellers to areas in the world where those strains occur.
• There is currently no vaccine available against serogroup B. Given the high levels of Men B in the UK, a safe and effective vaccine is needed. Several companies are now developing vaccines and early results look promising[10].
Useful contact organisations
The Meningitis Trust - 24 Hour helpline 0845 6000 800 - http://www.meningitis-trust.org
Meningitis Research Foundation - 24 Hour helpline 080 8800 3344 - http://www.meningitis.org
Meningitis UK - http://www.meningitisuk.org
References
1. Meningitis Research Foundation. What are meningitis and septicaemia? Available at: http://www.meningitis.org/disease-info/what-are-meningitis-septicaemia; accessed July 2011
2. Meningitis Research Foundation. Meningococcal disease. Available at: http://www.meningitis.org/disease-info/types-causes/meningoccal-disease; accessed July 2011.
3. Stephens DS, Greenwood B, Brandtzaeg P. Epidemic meningitis, meningococcaemia, and Neisseria meningitidis. Lancet. 2007;369(9580):2196–2210.
4. Meningitis Trust. Factsheet – Meningococcal disease. 2010. Available at: http://www.meningitis-trust.org/how-we-help/resources/; accessed July 2011.
5. Meningitis Trust. Meningitis signs and symptoms. Available at: http://www.meningitis-trust.org/Signs-Symptoms.html; accessed July 2011
6. Harrison LH. Prospects for vaccine prevention of meningococcal infection. Clin Microbiol Rev. 2006;19(1):142–164.
7. Department of Health. Immunisation against infectious disease. Updated July 2011. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_079917; accessed July 2011.
8. Meningitis UK. Thousands of lives saved thanks to vaccine success. Available at: http://www.meningitisuk.org/news-and-events/latest-news/thousands-of-lives-saved-thanks-to-vaccine-success.htm; accessed July 2011.
9. Meningitis UK. Meningitis UK welcomes news of Meningitis C vaccine success. Available at: http://www.meningitisuk.org/news-and-events/latest-news/meningitis-uk-welcomes-news-of-meningitis-c-vaccine-success.htm; accessed July 2011.
10. CMO annual report 2007. Available at: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/AnnualReports/DH_086176; accessed July 2011.