Meningococcal disease

Meningococcal disease is caused by a bacterium (bacteria germ) called Neisseria meningitidis. This germ can be found at the back of the throat or in the nose in about 10% of the community at any given time.

Most people who ‘carry’ this germ in their throat or nose won't get sick but they can spread it to other people who may become very ill. It is spread in the fine droplets that are shed during activities such as coughing and sneezing.

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What is meningococcal disease

Meningococcal disease is an uncommon but severe infection that occurs when the meningococcal germ ‘invades’ the body from the throat or nose. This is thought to happen soon after the germ has been acquired from a carrier.

It occurs in two main forms:

  • meningococcal septicaemia, when the germ invades the bloodstream and causes blood poisoning
  • meningococcal meningitis, when the germ infects the outer lining around the brain and spinal cord.

Sometimes septicaemia and meningitis can occur at the same time.

Meningococcal septicaemia can be very serious and cause death after even a very short illness. The patient usually is obviously sick, has a fever and may have marked joint or muscle pains; and there is often a rash. The rash may start anywhere on the body as tiny red or purple spots but they soon spread and enlarge to look like fresh bruises. The rash does not fade when pressure is applied to it, e.g. with the thumb or a clear glass.

The rash must be taken seriously as the person requires urgent medical attention.

The typical symptoms of meningococcal meningitis include fever, a stiff neck, severe headache, dislike of bright lights, vomiting, joint or muscle pains, drowsiness and even coma; there may also be a rash with the same features as those described above.

Symptoms

Typical symptoms include all of the following:

  • fever
  • a stiff neck
  • severe headache
  • dislike of bright lights
  • vomiting
  • joint or muscle pains
  • drowsiness and even coma
  • there may also be a rash.

Symptoms in young babies may be different and include:

  • refusing feeds
  • vomiting
  • a high-pitched moaning cry
  • irritability and dislike of being handled
  • blank staring expression
  • lethargy or drowsiness
  • pale blotchy complexion.

There are six different groups of the meningococcal bacteria that cause nearly all disease globally (A, B, C, W-135, X and Y).

Group C disease is now rarely seen because children have been vaccinated against this group at the age of 12 months since 2003.

Since 2016 cases of meningococcal W disease have increased nationally. There was an outbreak of meningococcal W disease in Central Australia in 2017.

The overall fatality rate of meningococcal disease is 8 to 10%.

How easy is it to catch meningococcal disease

Although the germ is spread in droplets that are shed from the nose or throat it is fortunately not easy to catch the disease. This is because the meningococcal germ does not survive for long outside the body. Close and prolonged contact with a carrier is usually required for the germ to spread to other people.

Evidence suggests that contact with saliva outside of the body is not important in the transmission of meningococcal disease. Therefore sharing of drink bottles does not pose a risk for meningococcal transmission.

Young children under five years of age, and young adults (15 to 24 years of age) are at highest risk of acquiring meningococcal disease and there is usually a seasonal increase in the winter to early spring months.

Even though it is hard to catch and uncommon, meningococcal disease is a feared disease that is often featured in the media. This is because it can be fatal even in healthy individuals and because outbreaks of meningococcal disease, although very infrequent, can occur.

Prevention

Some types of meningococcal disease can be prevented by vaccination (see below).

Sometimes cases of meningococcal disease can happen in clusters when bacteria spread from a carrier to more than one person. Treatment of a carrier with antibiotics has been shown to stop further spread but because there is no quick and accurate test to identify carriers, all of the ‘household contacts’ of a case are recommended to have antibiotic treatment.

The purpose of the antibiotic is to eliminate the germ from the nose or throat of the carrier in an effort to prevent further spread to others.

There is a small, but real risk for those who live in the same house as a person with meningococcal disease to also develop disease. As this may occur despite taking the antibiotic, contacts must also be told to be aware for the symptoms of the disease and in some circumstances may be offered vaccination.

Contacts of cases of meningococcal disease should share the information about the disease with their close contacts to raise awareness about signs and symptoms of meningococcal disease. Early presentation of possible cases to medical care is important. Any treating doctor should be made aware if the person presenting is a possible meningococcal contact.

Sometimes other contacts are also identified by public health authorities and given the above mentioned advice and antibiotic. However it is very important that the public health authorities are involved in the identification of other contacts because the antibiotic should be used very carefully.

Cigarette smoking, both active and passive, appears to increase the risk of a person developing meningococcal disease.

Vaccinations

There are three types of meningococcal vaccines available in Australia:

  • monovalent meningococcal C (MenC)
  • quadrivalent meningococcal A, C, W-135 and Y (MenACWY)
  • meningococcal B (MenB).

Find out more about the meningococcal vaccine.

Monovalent MenC

The meningococcal C vaccine was used in the NT until December 2017.

It was given as a combination MenC and Haemophilus influenza B vaccine called Menitorix.

Vaccination for meningococcal C is now given as part of the quadrivalent MenACWY vaccine.

Quadrivalent MenACWY

Quadrivalent meningococcal vaccines provide protection against meningococcal bacteria groups A, C, W-135 and Y.

They are available to all people aged one to 19 years across the Northern Territory as part of the NT vaccination schedule.

MenACWY vaccines may be recommended for travel to certain countries and for people with high risk medical conditions.

MenB

Vaccines to cover serogroup B meningococcal are recommended for:

  • children less than two years
  • people aged 15 to 19 years
  • people with high risk medical conditions.

One MenB vaccine brand can be given to children from six weeks of age.

MenB vaccines are not included on the national vaccination program but can be purchased privately with a script from your doctor.

Where to get the vaccine

Please see you local general practitioner, Aboriginal community controlled clinic, or urban or remote health clinic.

Find a community care centre or remote health service.

Contact

For more information contact your nearest Centre for Disease Control.

Last updated: 30 August 2018