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Meningococcal Disease, Meningitis, Septicemia

Neisseria meningitidis

Certain groups of people are at increased risk for meningococcal disease. For some of these groups, there are recommended vaccines that prevent two of the three major serogroups (“strains”) of Neisseria meningitidis bacteria that cause most illness in the United States. Vaccination is the best way to protect yourself against meningococcal disease.
Some risk factors include:

  • Age: Meningococcal disease is more commonly diagnosed among infants, adolescents and young adults. A vaccine is available and recommended for all 11 through 18 year olds. A vaccine is also available for infants and children 6 weeks through 10 years of age, but it is only routinely recommended for those with certain medical conditions or who are traveling to specific countries. Learn more about certain age groups being at risk.
  • Community setting: Infectious diseases tend to spread quickly wherever large groups of people gather together. As a result, first-year college students living in residence halls are at slightly increased risk compared with other persons of the same age. A vaccine is available and recommended for all first-year college students living in a residence hall. However, any college student can receive the vaccine to decrease their chances of getting meningococcal disease. People entering the military will receive a meningococcal vaccine before basic training. Learn more about those in community settings being at risk.
  • Certain medical conditions: There are certain diseases, medications and surgical procedures that put people at increased risk of meningococcal disease, such as not having a spleen. A vaccine is available and recommended for those with these conditions. Learn more about those with certain medical conditions being at risk.
  • Travel: Travelers to the meningitis belt in sub-Saharan Africa may be at risk for meningococcal disease, particularly during the dry season. Learn more about travelers at risk.

Causes

  • Meningococcal disease is caused by the bacterium Neisseria meningitidis, also called meningococcus. About 10% of people have this type of bacteria in the back of their nose and throat with no signs or symptoms of disease, called being ‘a carrier’. But sometimes Neisseria meningitidis bacteria can invade the body causing certain illnesses, which are known as meningococcal disease.

Transmission

  • Neisseria meningitidis bacteria are spread through the exchange of respiratory and throat secretions like spit (e.g., by living in close quarters, kissing). Fortunately, these bacteria are not as contagious as germs that cause the common cold or the flu. The bacteria are not spread by casual contact or by simply breathing the air where a person with meningococcal disease has been.
  • Sometimes Neisseria meningitidis bacteria spread to people who have had close or lengthy contact with a patient with meningococcal disease. People in the same household, roommates, or anyone with direct contact with a patient’s oral secretions, meaning saliva or spit, (such as a boyfriend or girlfriend) would be considered at increased risk of getting the infection.
  • People who qualify as close contacts of a person with meningococcal disease should receive antibiotics to prevent them from getting the disease. This is known as prophylaxis (pro-fuh-lak-sis). The health department investigates each case of meningococcal disease to make sure all close contacts are identified and receive prophylaxis. This does not mean that the contacts have the disease; it is to prevent it.

Meningitis

A common outcome of meningococcal infection is meningitis. When caused by Neisseria meningitidis bacteria it is known as meningococcal meningitis. When someone has meningococcal meningitis, the protective membranes covering their brain and spinal cord, known as the meninges, become infected and swell. The symptoms include sudden onset of fever, headache, and stiff neck. There are often additional symptoms, such as

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  • Nausea
  • Vomiting
  • Photophobia (increased sensitivity to light)
  • Altered mental status (confusion)

The symptoms of meningococcal meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure.
In newborns and infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The infant may appear to be slow or inactive, irritable, vomiting or feeding poorly. In young children, doctors may also look at the child’s reflexes, which can also be a sign of meningitis.
If you think you or your infant or child has any of these symptoms, call the doctor right away.
Meningococcal meningitis is very serious and can be fatal. In fatal cases, deaths can occur in as little as a few hours. In non-fatal cases, permanent disabilities can include hearing loss and brain damage.

Meningococcal Septicemia (aka Meningococcemia)

Another common outcome of meningococcal infection is bloodstream infection, either septicemia or bacteremia. The more serious of the two is septicemia. When caused by Neisseria meningitidis bacteria it is known as meningococcal septicemia or meningococcemia. This is the more dangerous and deadly illness caused by Neisseria meningitidis bacteria. When someone has meningococcal septicemia, the bacteria enter the bloodstream and multiply, damaging the walls of the blood vessels and causing bleeding into the skin and organs.
Symptoms may include:

  • Fatigue
  • Vomiting
  • Cold hands and feet
  • Cold chills
  • Severe aches or pain in the muscles, joints, chest or abdomen (belly)
  • Rapid breathing
  • Diarrhea
  • In the later stages, a dark purple rash (see photos)

Prevention

  • Vaccination
  • Antibiotics
  • Infection

 

Keeping up to date with recommended immunizations is the best defense against meningococcal disease. Maintaining healthy habits, like getting plenty of rest and not coming into close contact with people who are sick, can also help.

Vaccination

There is a vaccine for the bacteria that cause meningococcal disease. However, available vaccines do not cover all serogroups (“strains”) of Neisseria meningitidis bacteria. Like with any vaccine, meningococcal vaccines are not 100% effective. This means that even if you have been vaccinated, there is still a chance you can develop a meningococcal infection. People should know the symptoms of meningococcal meningitis and meningococcal septicemia since early recognition and quick medical attention are extremely important.
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Learn more about who should get this vaccine.

Antibiotics

Sometimes Neisseria meningitidis bacteria spread to other people who have had close or lengthy contact with a patient with meningococcal disease. People in the same household, roommates, or anyone with direct contact with a patient’s oral secretions (saliva) (such as a boyfriend or girlfriend) would be considered at increased risk of getting the infection. People who qualify as close contacts of a person with meningococcal disease should receive antibiotics to prevent them from getting the disease. This is known as prophylaxis.

Infection

If your doctor confirms that you have meningococcal disease, your body will develop a natural defense (immunity) to some similar types of future infections. However, like with the vaccine, this protection does not last a lifetime and is not perfect. Therefore, routine meningococcal vaccines are still recommended. If you get meningococcal disease twice, it is highly possible that you have an underlying immune deficiency, which your doctor should evaluate.
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