Frequently asked questions
Table of Contents
Meningococcal disease is a severe infection that occurs when the meningococcal germ ‘invades’ the body from the throat or nose. It does not occur in the people who carry the germ but rather occurs in people who have very recently (within the previous 7 days) Acquired the germ from a healthy ‘carrier’.
Meningococcal disease occurs in two main forms or it can occur as a combination of these two forms. Meningococcal septicaemaia occurs when the germ invades the bloodstream and causes blood poisoning. Meningococcal meningitis occurs when the the germ infects the outer lining around the brain and spinal cord.
The meningococcus is a bacterium that can be found at the back of the throat or in the nose in about 10% of the community at any given time. Although most people who ‘carry’ this germ in their throat or nose remain quite well, they are able to spread it to others, a few of whom may subsequently become very ill. It is spread in the fine droplets that are shed through coughing, sneezing and spluttering.
Anyone, anywhere can contract meningococcus, but those most at risk are children under 5 years, teenagers and young adults, and older people. Most cases are isolated and not related to another case or an ‘outbreak’.
Meningococcal disease presents as meningitis, or rarely, as chronic meningococcemia or septic arthritis. The disease is usually characterised by the appearance of a rash, which progressively forms larger spots, which may merge into lesions. Petechial rash in association with sudden onset of fever, headaches and stiff neck, vomiting and drowsiness is highly suggestive of meningococcal meningitis. The causative agent is a gram-negative diplococcus, Neisseria meningitidis, of which there are 13 known serogroups, each having a different capsular polysaccharide. Over 90 per cent of meningococcal disease is caused by serogroups A, B or C.
Transmission of Neisseria meningitidis is primarily via respiratory droplets from the nose and throat of an infected person. The organism may be asymptomatically carried by up to 25 per cent of the community, and only a few of these will develop invasive disease. It may cause sudden serious illness and death in a previously healthy person, and as a result can cause considerable anxiety and panic in a community.
Close contact with a person who has meningococcal disease poses an increased risk of infection; the relative risk compared to the general population can be greater than 1000. The risk of infection from a case to contacts may persist for many months, but the greatest risk is during the first five weeks following the onset of disease in the index case (original case).
Meningococcal disease is most frequently seen in winter and early spring. Upper respiratory tract infections particularly those caused by influenza A may increase the risk of invasive meningococcal disease.
A vaccine against meningococcal groups A, C, W135 and Y can be given to people traveling to areas of the world where these strains occur, has been available to some years. I t is effective in about 80% of those who receive it, but it is not effective in children under the age of 18 months and only offers protection for about 3 years.
A new, more effective conjugated vaccine for the meningococcal C strain is available in Australia. This vaccine can potentially protect infants and children, as well as adults, and offers immunized individuals longer-term protection against meningococcal C disease. Clinical experience in the UK has confirmed the value of this vaccine in reducing outbreaks of this disease among paediatric populations.
There is no vaccine against meningococcal group B, which is still the most common group causing meningitis and meningococcal septicaemia.
Awareness of the signs and symptoms of meningitis and septicaemia, and being prepared to take action swiftly is very important.
The rash may take many forms. It may start as a single spot or tiny pink or red pinpricks or pimples that later develop into purple bruises. IMPORTANT: Don't wait for the rash as it doesn't always appear, however if it does appear with the other symptoms, please TREAT IT AS A MEDICAL EMERGENCY
Prompt diagnosis of meningococcal septicaemia and meningitis andpreadmission treatment of presumptive cases can be life saving.
Bacterial meningitis and meningococcal septicaemia demand immediate treatment with antibiotics.
Only people who have come into close contact with patients suffering from bacterial meningitis and meningococcal septicaemia require antibiotics. (Close contacts are people living or sleeping in the same household or who have intimately kissed the patient.) School friends and work mates of the patient with meningococcal disease are rarely at higher risk unless several cases occur together.
Antibiotics are given to kill off any meningococcal bacteria, which may be carried in the back of the nose and throat. This reduces the risk of passing the bacteria on to others. Research suggests that smoking in the household setting may increase the risk of a child contracting bacterial meningitis.
Apart from vaccines, there is no known way to protect against meningitis and meningococcal septicaemia.
Viral meningitis does not respond to antibiotics; treatment is based on rest and good nursing care.
After you have seen a doctor, if your child or friend becomes more unwell or you continue to be worried, seek further help.
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