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What is Meningococcal Disease?


meningococcal

Meningococcal disease is a bacterial illness caused by the aerobic, gram-negative bacteria Neisseria meningitidis (N. meningitidis).1 Thirteen types (serogroups) of N. Meningitis or meningococci have been identified2 with six found to be responsible for epidemics resulting in invasive meningococcal disease. These six serogroups include A, B, C, X, W and Y.3 Most frequently, invasive meningococcal disease can cause inflammation of the meninges of the brain and spinal cord (meningitis) and a serious bloodstream infection (septicemia/meningococcemia).4

Symptoms of meningococcal meningitis include headache, stiff neck and fever while symptoms of meningococcemia include rash and fever. Meningitis is the most common presentation of invasive meningococcal disease and accounts for approximately 75 percent of all cases. 20 percent of invasive meningococcal disease cases result in meningococcemia. Both meningitis and meningococcemia can be fatal, with 10 to 15 percent of cases resulting in death.5 Humans are the only species known to carry N. meningitidis and invasive meningococcal disease most frequently occurs in late winter or early spring.6

Symptoms of meningitis begin to appear between 3 and 7 day after exposure to meningococcal bacteria. At first, symptoms may appear mild and similar to cold or flu symptoms and may include headache, fever, aches and pains. As the illness progresses, additional symptoms can include skin rash, severe headache, stiff neck, nausea, vomiting, inability to look at bright lights, mental confusions and irritability, extreme fatigue/sleepiness, convulsions and unconsciousness. In babies, symptoms can include a high-pitched moaning cry, difficulty or refusal to feed, and the fontanel, the soft area on the top of the head, may also be bulging.7 8

Approximately 10-20 percent of adolescents and adults are asymptomatic carriers of meningococci. Although they have no symptoms of the disease, they carry the bacteria in the back of their throat and can transmit the disease to others.9 Less than one percent of individuals who carry meningococci will develop invasive meningococcal disease. Invasive disease occurs when the meningococci bacteria passes through the mucous cells and invades the bloodstream. Often, invasive meningococcal disease has been noted after the development of an upper respiratory infection.10

Meningococcal disease is not easily spread.  Transmission of the disease requires one to be susceptible to the disease and to have direct close and lengthy contact, such as kissing or sharing a toothbrush, with a person who is colonizing the bacteria.11 12 Studies have also found that genetics play a role in both one’s susceptibility to invasive meningococcal disease as well as to disease outcomes.13 Meningococcal disease is treated with antibiotics, and cephalosporins are currently considered to be the antibiotic of choice for treatment at this time.14 Persons who may have been exposed to meningococcal bacteria through close contact with a person diagnosed with the invasive disease can be treated with antibiotics such as rifampin or ciprofloxacin prophylactically to prevent disease development.15

Invasive meningococcal disease is very rare in the United States. In 2017, there were approximately 350 cases of invasive meningococcal disease reported to the CDC.16 Between 1998 and 2007 and prior to the introduction of vaccines targeting meningococcal serogroups A, C, Y, and W-135, meningococcal disease rates had already decreased substantially to less than 1 case per 100,000 population.17

NVIC “Quick Facts” is not a substitute for becoming fully informed about Meningococcal disease, meningitis and the Meningococcal vaccine. NVIC recommends consumers read the more complete information following the "Quick Facts", as well as the vaccine manufacturer product information inserts, and speak with one or more trusted health care professionals before making a vaccination decision for yourself or your child.

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References

1 CDC Meningococcal Disease - Neisseria meningitidis Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

2 Aquino Gondim, FDA Meningococcal Meningitis – Background Medscape Jul. 16, 2018

3 WHO Meningococcal Meningitis Feb. 19, 2018

4 CDC Meningococcal Disease Mar. 28, 2017

5 CDC Meningococcal Disease – Clinical Features Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

6 CDC Meningococcal Disease - Epidemiology Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

7 WebMD Meningitis Symptoms Warning Signs Jun. 13, 2017

8 CDC. Meningococcal Disease. April 2017

9 Meningitis Research Foundation of Canada Meningococcal Disease - Meningococcus (Neisseria meningitis) No Date

10 CDC Meningococcal Disease - Neisseria meningitidis Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book). 13th ed. 2015.

11 CDC Meningococcal Disease Causes and Spread to Others Mar. 28, 2017

12 Fisher, BL. What You Should Know About Meningococcal Disease & The Vaccine. July 15, 2011.

13 Brouwer MC, van der Beekn D. Genetics in Meningococcal Disease: One Step Beyond. Clin. Infect. Dis. 2009; 48(5); 595-599.

14 Aquino Gondim, FDA Meningococcal Meningitis Treatment & Management – Pharmacologic Care Medscape Jul 16, 2018

15 Aronin SI, Quagliarello VJ Bacterial Meningitis - Preventive Pearls Infect Med. 2003;20(3) 

16 CDC Enhanced Meningococcal Disease Surveillance report, 2017 : confirmed and probable cases reported to the National Notifiable Diseases Surveillance System, 2017 Nov. 21, 2018

17 Cohn AC, MacNeil JR, Harrison LH et al. Changes in Neisseria meningitidis disease epidemiology in the United States, 1998-2007: implications for prevention of meningococcal disease. Clin Infect Dis. 2010 Jan 15;50(2):184-91


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