1. 5-25% PER CENT OF PEOPLE CARRY MENINGOCOCCAL BACTERIA
Meningococcal disease (or ‘invasive meningococcal disease’ (IMD)) is a rare disease that is caused by the bacterium Neisseria meningitidis. It is a serious illness that usually causes meningitis (inflammation of the lining of the brain and spinal cord) and/or septicaemia (blood poisoning).
Between 5-25% per cent of people carry meningococcal bacteria at the back of the nose and throat. These people do not show any signs of illness or symptoms of IMD, hence, these people are called carriers.
2. MENINGOCOCCAL DISEASE CAN PROGRESS RAPIDLY
Meningococcal disease is a potentially devastating infection and can progress rapidly, causing serious disability or death within 24 hours. The bacteria spread causing septicaemia (an infection in the bloodstream) and/or meningitis (an infection of the membranes that line the spinal cord and brain).
Early treatment is vital as people can become extremely unwell very quickly. There is a 5-10% mortality rate for ill patients even with rapid treatment, so it is important that if you suspect Meningococcal Disease, you should present to the emergency department as soon as possible. Meningococcal disease is potentially fatal and should always be viewed as a medical emergency.
3. MENINGOCOCCAL DISEASE CAN CAUSE SERIOUS DISABILITY OR DEATH
Up to 1 in 10 of those infected by meningococcus may die and up to 1 in 5 may suffer serious long-term disabilities including brain damage, deafness or loss of limbs.
Long-term effects of the disease include:
loss of arms and legs
deformity of arms and legs
aches and stiffness in the joints
scars on the skin
ringing in the ears (tinnitus)
deafness in one or both ears
kidney or liver failure
headaches
blurred or double vision
blindness
learning difficulties
4. MENINGOCOCCAL DISEASE SYMPTOMS MAY BE HARD TO RECOGNISE
Meningococcal disease has a range of symptoms, depending on its severity.
Symptoms may include:
sudden onset of fever
headache
neck stiffness
joint pain
sensitivity to bright lights
nausea and vomiting
rash of red-purple spots or bruises
The distinctive meningococcal rash does not disappear with gentle pressure on the skin ie. does not blanch. The rash is often a sign of more advanced disease, however, the rash does not always occur.
5. MENINGOCOCCAL IS SPREAD THROUGH CLOSE AND PROLONGED CONTACT
Meningococcal is spread from person-to-person through respiratory and throat secretions.
Transmission requires close and prolonged contact with a person carrying the bacteria who is usually well. An example of 'close and prolonged contact' including intimate kissing, sneezing or coughing on someone or living in close quarters with a carrier.
6. THE NUMBER OF CASES OF MENINGOCOCCAL DISEASE IN AUSTRALIA HAS INCREASED IN RECENT YEARS
Vaccination programs have successfully reduced the incidence of invasive meningococcal disease (IMD) caused by serogroup C. However, IMD caused by serogroup B continues to occur in Australia, and the incidence of IMD caused by serogroups W and Y has increased in recent years.
7. OF THE 13 SEROGROUPS (SUBTYPES), GLOBALLY, SEROGROUPS A, B, C, W, Y MOST COMMONLY CAUSE MENINGOCOCCAL DISEASE
There are 13 known meningococcal subtypes (serogroups), distinguished by differences in surface of the bacterium’s outer layer.
Globally, serogroups A, B, C, W, Y most commonly cause disease. In Australia serogroups B, W and Y cause the majority of disease.
8. NO SINGLE VACCINE PROTECTS AGAINST ALL MENINGOCOCCAL SEROGROUPS
Several vaccines are available in Australia to prevent meningococcal disease. However, no single vaccine protects against all serogroups:
2 vaccines protect against meningococcal serogroup B — MenB vaccines
2 vaccines protect against meningococcal serogroup C only — MenC vaccine and Hib-MenC vaccine (combined with Haemophilus influenzae type b)
3 vaccines protect against meningococcal serogroups A, C, W-135 and Y — MenACWY (quadrivalent) conjugate vaccines.
9. CHILDREN UNDER 5 YEARS AND ADOLESCENTS AGED 15-19 ARE MOST AT RISK
Meningococcal disease can affect people of any age. Infants and children under 5 years of age are most at risk, followed by adolescents 15-19 years of age.
This is why in Australia, infants and children aged 6 weeks to <2 years and healthy adolescents aged 15-19 years are strongly recommended to receive meningococcal ACWY and meningococcal B immunisations.
10. SMOKING TOBACCO INCREASES THE RISK OF CARRYING MENINGOCOCCAL BACTERIA IN THE UPPER RESPIRATORY TRACT
Adolescents and young adults aged 15–24 years who are current smokers are strongly recommended to be immunised against meningococcal B and ACWY.
Smoking tobacco increases the risk of carrying meningococcal bacteria in the upper respiratory tract. It also increases the risk of transmitting the bacteria to close contacts. Smokers are at greater risk of meningococcal disease because they have higher meningococcal carriage rates than non-smokers.
11. THE AUSTRALIAN NATIONAL IMMUNISATION PROGRAM (NIP) DOES NOT FULLY COVER AGAINST ALL THE SEROGROUPS THAT COMMONLY CAUSE DISEASE
The meningococcal ACWY immunisation is included in the NIP for 12 month olds and adolescents aged 15-19 years, however the meningococcal B immunisation is not included. It would therefore be important for you to further discuss with your child’s doctor about whether further meningococcal immunisations are required.
12. MENINGOCOCCAL IMMUNISATION IS ALSO STRONGLY RECOMMENDED FOR PEOPLE TRAVELLING TO CERTAIN REGIONS
Immunisation against meningococcal ACWY is strongly recommended for people who are planning to travel to regions that may involve a greater risk of exposure to meningococcal serogroups A, C, W and Y.
These people include:
People travelling to, or living in, parts of the world where epidemics of serogroups A, C, W-135 or Y meningococcal disease occur, particularly the ‘meningitis belt’ of sub-Saharan Africa
People travelling to mass gatherings, such as pilgrims travelling to the Hajj
13. FEVER IS A COMMON SIDE EFFECT AFTER MENINGOCOCCAL B VACCINATION IN YOUNG CHILDREN
Fever is a common side effect after meningococcal B vaccination in young children. Therefore, paracetamol is recommended in children < 4 years of age to reduce the likelihood and severity of fever. The first dose of paracetamol should be given 30 minutes prior to the vaccination, or as soon as possible after vaccination, even if children do not have a fever. This should be followed by 2 more doses of paracetamol given 4 to 6 hours apart.
See your doctor to discuss whether you or your child requires immunisation against meningococcal disease.
Dr Lufi and Dr Leah
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