Meningococcal Disease

About This Disease

Meningococcal disease is caused by the bacterium Neisseria meningitidis. There are at least 13 types of Neisseria meningitidis, called “serogroups.” Serogroups A, B, C, W, and Y cause most meningococcal disease worldwide. Three of these serogroups (B, C, and Y) cause most of the illness seen in the United States.

The two most common types of meningococcal infections are meningitis (infection of the membranes covering the brain and spinal cord) and septicemia (bloodstream infection). Both of these are very serious and can be deadly in a matter of hours.

Even with antibiotic treatment, 10 to 15% of people with meningococcal disease will die. As many as 20% of survivors will have long-term disabilities, such as loss of limb(s), deafness, nervous system problems, or brain damage.

Infants less than one year old and adolescents 16 through 23 years old have higher rates of disease than other age groups. However, cases occur in all age groups, including the elderly. Others at risk for meningococcal disease include:

Persons with certain medical conditions that affect the immune system
Persons taking eculizumab (Soliris®)
Microbiologists routinely exposed to the bacteria in the laboratory
Those identified as being at increased risk because of an outbreak of meningococcal disease
Travelers to a country where meningococcal disease is epidemic or highly endemic
First-year college students who live in residence halls
Military recruits

Household or close contacts of case patients are at the highest risk for developing meningococcal disease.

More information about risk factors for meningococcal disease.

Signs and Symptoms

Meningococcal meningitis:

The most common symptoms include:

Fever
Headache
Stiff neck

Additional symptoms include:

Nausea
Vomiting
Photophobia (eyes being more sensitive to light)
Confusion (altered mental status)

In newborns and babies:

Inactivity
Irritability
Vomiting
Feeding poorly

Meningococcal septicemia:

Symptoms may include:

Fever
Fatigue
Vomiting
Cold hands and feet
Cold chills
Severe aches or pain in the muscles, joints, chest or abdomen
Rapid breathing
Diarrhea
Dark, purple rash (in later stages)

The incubation period of meningococcal disease is 3 to 4 days (range: 2 to 10 days).

Transmission

People spread meningococcal bacteria to others by exchanging respiratory and throat secretions (saliva or spit), especially if living in the same household. Generally, it takes close (for example, coughing or kissing) or lengthy contact to spread these bacteria.

Fortunately, meningococcal bacteria are not as contagious as the germs that cause the common cold or the flu. People do not catch these bacteria through casual contact or by breathing air where someone with meningococcal disease has been.

Close contacts of someone with meningococcal disease should receive antibiotics ideally within 24 hours after the case is identified to help prevent them from getting the disease. People who are not a close contact of a patient with meningococcal disease do not need to take antibiotics.

Diagnosis

Meningococcal disease can be difficult to diagnose because the signs and symptoms are often similar to those of other illnesses. If a healthcare provider suspects meningococcal disease, they will collect samples of blood or cerebrospinal fluid (fluid near the spinal cord) and test to see if there is an infection.

Treatment

Meningococcal disease is treated with a number of effective antibiotics. It is important that treatment is started as soon as possible, to help reduce the risk of dying.

Depending on how serious the infection is, people with meningococcal disease may need other treatments, including:

Breathing support
Medications to treat low blood pressure
Wound care for parts of the body with damaged skin

Risk in Hawaii

Summary of Reported Cases of Notifiable Diseases

Prevention

There are three types of meningococcal vaccines available in the United States:

Protect against serogroups A, C, W, and Y:
- Meningococcal conjugate vaccine (MenACWY)
- Meningococcal polysaccharide vaccine (MPSV4)
Protect against serogroup B:
- Serogroup B meningococcal vaccine (MenB)

The Centers for Disease Control and Prevention recommends vaccination with MenACWY for all preteens and teens at 11 to 12 years old, with a booster dose at age 16 years.

Teens and young adults (aged 16 through 23 years) may also be vaccinated with a MenB vaccine.

Other children and adults, especially those at increased risk for meningococcal disease may be recommended to receive meningococcal vaccines. Some persons may need additional doses for adequate protection. Discuss your specific situation with your or your child’s health care professional.

MPSV4 is recommended only for certain people older than 55 years.

Regardless of immunization status, close contacts of a person with meningococcal disease should receive antibiotics ideally within 24 hours after the case is identified to help prevent them from getting the disease.