What is meningococcal disease?
Meningococcal disease is a serious infection caused by serotypes A, B, C, W-135 and Y of the bacteria, Neisseria meningitidis.
Meningococcal disease occurs throughout the year. However, the incidence is highest in the late winter and early spring. Approximately 800–1,200 cases occur annually in the United States. Most cases are sporadic; very few cases occur as part of an outbreak.
The mortality rate is approximately 10%, and 11%–19% of survivors have long-term sequelae (e.g., neurologic disability, limb or digit loss, and hearing loss).
How is meningococcal disease spread?
Meningitis bacteria can spread by direct and indirect contact with oral and nasal secretions/saliva of an infected person. Kissing, sharing cups or food utensils, or sharing cigarettes can transfer these fluids from an infected person and increase the risk of getting the disease.
Luckily, the bacteria is not as contagious as the common cold or flu, and does not spread by casual contact or by breathing the air where a person who is sick has been.
Who is at risk of getting meningococcal disease?
In the United States, the disease is seen in the very young and very old. In addition, outbreaks have been seen in adolescents and young adults aged 16 through 21 years.
College students are particularly susceptible as they live and work in close quarters. In addition persons with certain illnesses that predispose them to infections are at increased risk. During an outbreak, active and passive smoking, alcohol consumption, and bar patronage also increase the risk of contracting the disease from an infected person.
In some developing countries, the rates are higher and epidemics are common. Travelers to developing countries should always check with a health care provider to see if they are going to an endemic area and get vaccinated before travel.
What are the clinical features of meningococcal disease?
People who are infected with N. meningitidis get very sick very quickly. Patients can have one of the following presentations:
Meningitis is the most common presentation of meningococcal disease. Patients experience sudden onset of fever, headache, and stiff neck, often accompanied by other symptoms, such as nausea, vomiting, photophobia (eye sensitivity to light), and change in mental status.
Meningococcal sepsis (bloodstream infection) can occur in 5% to 20% of infections. Patients may have an abrupt onset of fever, and fatigue, nausea, vomiting, cold hands and feet, chills, severe muscle aches, abdominal pain, rapid breathing, and diarrhea. Patients may also develop a rash all over the body including the palms and soles.
Less common presentations include meningococcal pneumonia which can occur in 5% to 15% of cases.
How can meningococcal disease be treated?
Antibiotics are very effective in treating the disease. However, as patients can get very sick quickly, early diagnosis and treatment are important for a good prognosis.
If you have been exposed to someone who is diagnosed with meningococcal disease, antibiotics can also prevent an infection.
What can you do to protect yourself?
Vaccines are available to protect against four common serotypes that cause infections in young adults (A, C, W-135 and Y). Vaccination is strongly recommended for all persons before college entry. All college students up to age 21 living in residence halls should also consider vaccination. Vaccination is also recommended during an outbreak due to these serogroups.
Vaccines against serotype B have recently become available. At present, these vaccines are not recommended for routine immunization. They are being used in organizations (campuses, residential facilities) where a meningitis outbreak has occurred and found to be due to serotype B.
You can also protect yourself by safe health practices. Washing hands frequently, covering your mouth when sneezing and coughing and not sharing food utensils, and cigarettes can all help prevent the spread of meningitis and other illnesses such as the common cold and flu.
Are the vaccines available at Health Services?
Most people receive the vaccine that protects against four of the common serotypes when they are adolescents, and a large majority of the students living on campus have received the vaccine before coming to college. For those who are not vaccinated, Health Services has started contacting them individually to offer the vaccine.
To date, the multi-dose vaccine against serotype B is not part of the vaccinations recommended by the Center for Disease Control (CDC) for all adolescents and young adults. The Rhode Island Department of Health (RI-DOH) is not recommending mass immunization against this serotype. We are working closely with RI-DOH to follow any change in recommendations.
If you have any questions about vaccines, want to check your vaccination status or to schedule an appointment, contact our nursing staff at 401-863-1330.