Meningococcal disease is a serious illness caused by a bacterial infection. In the United States, it is the leading cause of
bacterial meningitis
in children ages 2-18 years. Bacterial meningitis is an infection and inflammation of the meninges, the membranes that surround the brain and spinal cord. It can cause death within hours, so quick diagnosis and treatment are vital.
Meningococcal disease is usually spread by direct contact with discharge from the mouth or throat of an infected person (eg, kissing). In general, it is not spread by casual contact.
Menigococcal disease is most common in infants younger than one year of age and people with certain medical conditions (eg, lack of spleen). College freshmen who live in dormitories also have an increased risk of developing meningococcal disease.
It is estimated that about 2,600 people in the United States develop meningococcal disease each year. Approximately 10%-15% of these people die, and another 11%-19% lose their arms or legs, become deaf, have nervous system problems, become mentally retarded, or suffer seizures or
strokes.
Symptoms of meningitis include:
- High fever
- Headache
- Very stiff, sore neck
- Red or purple skin rash
- Cyanosis (bluish skin color)
- Nausea
- Vomiting
- Photophobia (sensitivity to bright lights)
- Sleepiness
- Mental confusion
Symptoms in newborn and infants can be hard to distinguish. These may include:
- Inactivity
- Unexplained high fever or low body temperature
- Irritability
- Vomiting
- Jaundice
- Feeding poorly or refusing to eat
- Tautness or bulging of soft spots between skull bones
- Difficulty awakening
When treatment is provided immediately, more than 90% of all people with bacterial meningitis survive. Treatment may include antibiotics, corticosteroids, and fluid replacement.
There are two meningococcal vaccines available in the United States: the meningococcal polysaccharide vaccine (MPSV4) and the meningococcal conjugate vaccine (MCV4).
Both vaccines are made from parts of the meningococcal bacteria, and neither contains live bacteria. The MPSV4 injection is given by injection under the skin and the MCV4 vaccine is given by injection into the muscle. Both vaccines should be refrigerated prior to administration.
The MCV4 vaccine is recommended for all children at their routine preadolescent visit (11-12 years of age). In addition, for adolescents entering high school who have never gotten MCV4, a dose is recommended before high school entry. The vaccine is also recommended for people at increased risk for meningococcal disease, including college freshmen living in dormitories, scientists routinely exposed to meningococcal bacteria, United States military recruits, people traveling to or living in parts of the world where meningococcal disease is common (eg, parts of Africa), people with a damaged or removed spleen, people with immune system disorders, and people who might have been exposed to meningitis during an outbreak. People ages two years and older should get one dose of the vaccine.
The MCV4 vaccine is preferred for children 2-10 years old who are in high-risk group. MCV4 is recommended if the person received MPSV4 at least 3 years before, and remains at increased risk for infection*.
MCV4 is the preferred vaccine for people 11-55 years of age, but MPSV4 can be used if MCV4 is not available.
The meningococcal vaccine, like all vaccines, has the potential to cause serious problems, such as severe allergic reactions. But the risk of meningococcal vaccine causing serious harm or death is extremely small.
Mild problems associated with the meningococcal vaccine include redness or pain at the injection site or a fever. Rarely, people who have received the MCV4 vaccine have developed a serious nervous system disorder called
Guillain-Barre syndrome.
People who have had a life-threatening allergic reaction to a previous dose of a meningococcal vaccine or any of the components of the vaccine to be given should not receive the vaccination.
People who are moderately or severely ill should wait until they recover to receive the vaccine.
Finally, people who have ever had Guillain-Barre syndrome should talk with their doctor before getting the MCV4 vaccine.
Meningococcal vaccines may be given to pregnant women, but the MCV4 vaccine has not been extensively studied in pregnant women, so it should be used only if it is clearly needed.
Preventive antibiotics may be given to healthcare workers or family members in close contact with people infected with meningococcal disease.
In the event of a meningococcal disease outbreak, close contacts of infected people and people who are at increased risk of developing meningococcal disease should receive a meningococcal vaccine if they are eligible for it. In addition, antibiotics may be recommended for close contacts of infected people.
