Meningococcal infection factsheet
Meningococcal meningitis and meningococcal septicaemia are systemic infections caused by the bacteria Neisseria meningitidis. Humans are the only known reservoir for Neisseria meningitidis.
- Meningitis: inflammation of the meninges (lining of the brain)
- Septicaemia: bacteria enters the bloodstream resulting in blood poisoning
Neisseria meningitidis is commonly found in the back of the throat or nose and will only occasionally cause disease. It is unknown why some individuals carry the bacteria without them causing harm while others go on to develop meningococcal disease. Approximately 10% of the population will carry Neisseria meningitidis, with the highest carriage (around 25%) in 15-19 year olds. Infection is not easily spread. It is transmitted from person to person by inhaling respiratory secretions from the mouth and throat or by direct contact (kissing). Close prolonged contact is usually required to transmit the bacteria. They do not live long outside the body.
Early signs and symptoms of meningococcal disease may be non-specific and therefore difficult to distinguish from influenza or other diseases. Early symptoms include fever, vomiting, malaise and lethargy.
For more detailed information on the symptoms of meningococcal disease, please visit the Meningitis Research Foundation and Meningitis Trust web sites.
What is meningococcal disease?
- Meningococcal disease is a serious illness caused by a bacterium known as meningococcus.
- Meningococci are bacteria found naturally at the back of the throat or nose in about 10% of the population.
- Many adults and children carry these bacteria without ill effects.
- Many of the meningococci seem to be harmless and may prevent more dangerous meningococci getting into the body.
- Only rarely do meningococci overcome the body's defences and cause illness.
- When this does occur, the bacteria can cause meningitis (infection and inflammation of the lining of the brain) and a severe condition that can spread throughout the body in the blood called septicaemia (blood poisoning).
- There are a number of different groups of meningococci. Prior to the introduction of Men C vaccine in 1999/2000 around 60-65% of cases in the UK were caused by Group B strains and Group C strains caused around 35-40% of cases. The introduction of Men C vaccine had a rapid impact with a marked reduction in Group C cases. From 2006/07 there have been less than 30 Group C cases each year in England and Wales compared to 955 in 1998/99 before the vaccine became available. Consequently Group B strains now account for around 90% of all cases of meningococcal disease with only around 1-2% of cases caused by Group C strains.
- Since 2000, the MenC vaccination programme has prevented over 9000 cases of serious disease and more than 1000 deaths. There have been only 2 deaths in children and young people under 20 in the last 5 years, compared to 78 deaths the year before the vaccine was introduced.
Who catches meningococcal disease?
- Provisionally, there were 896 cases of meningococcal disease confirmed in England and Wales in 2009/10; 785 of these cases were confirmed as Group B and only 17 as Group C.
- It is not known why some people become ill while others remain symptomless 'carriers' of the bacteria.
- Disease can occur at any age. However, most cases occur in children under four. The next highest incidence is recorded for teenagers between 15 and 19 years of age.
- Most cases occur without any connection to other cases (sporadic cases), sometimes two or more cases are connected by those affected having close contact (outbreaks).
- In some poorer countries, such as in West and Central Africa and Iran, there are occasional epidemics.
How do you catch meningococcal disease?
- Meningococcal disease is not highly infectious.
- The bacteria are passed by close contact, so family members of a case and others who have close contacts with a case may be spreading the same germs. This usually means household or kissing contacts.
- Close contact in residential accommodation, such as student halls of residence, and schools can also give the opportunity for the spread of infection.
- As the bacteria cannot survive for long outside the human body, infection cannot be caught from water supplies, swimming pools, or buildings.
What symptoms might make you suspect someone has meningococcal disease?
Someone with the disease will become very ill, though not all the symptoms will occur at once.
In children and adults symptoms can include:
- sudden onset of a high fever
- a severe headache
- dislike of bright lights (photophobia)
- painful joints
- drowsiness that can deteriorate into a coma
Symptoms are harder to identify in babies but include:
- a fever while the hands and feet are cold
- high pitched moaning or whimpering
- blank starring, inactivity, hard to wake up
- poor feeding
- neck retraction with arching of the back
- pale and blotchy complexion
- Septicaemia occurs if the bacteria enter the bloodstream. A characteristic rash develops and may start as a cluster of pinprick blood spots under the skin, spreading to form bruises under the skin. The rash can appear anywhere on the body. It can be distinguished from other rashes by the fact that it does not fade when pressed under the bottom of a glass (the tumbler test).
- Symptoms can develop within hours.
How serious is meningococcal disease?
- The bacteria only rarely give rise to meningococcal disease. But when they do infection spreads rapidly and is fatal in about 10% of cases (up to 50% with septicaemia).
- If disease is diagnosed early and treated promptly most people make a full recovery.
- However, about 1 in 8 people who recover experience some long term effects. These can include headaches, stiffness in the joints, epileptic fits, deafness and learning difficulties.
How can you treat someone with meningococcal disease?
- Antibiotics are used to treat meningococcal disease
- The earlier the treatment, the better the prospect of recovery. Often GPs will give treatment even before the person is admitted to hospital.
- If you suspect someone may have meningococcal disease, contact the doctor immediately. If the doctor is unavailable they should be taken to the nearest casualty department. Prompt action is vital.
How soon can a child be back at school after meningococcal disease?
- All cases of meningococcal meningitis and septicaemia must be notified to the local health authority. After notification the Consultant in Communicable Disease Control (CCDC) will give specific advice on any action that needs to be taken.
- Once a child has recovered from meningococcal disease and has been treated to clear the infection, they can return to school.
- There is no reason to exclude any siblings or other close contacts of the case from school.
Can you prevent meningococcal disease?
- A vaccine against meningococci group C was introduced in 1999/2000. It gives good protection. See the Vaccination for Meningococcal disease page for more information.
- There is as yet no vaccination for the other common group of meningococci in the UK (group B).
- Antibiotics are recommended for close contacts of a case to prevent further spread of infection.
- If group C is involved, the vaccine may be given as well as antibiotics.
- Specialist doctors called Consultants in Communicable Disease Control (CCDC) will be advising what else should be done.
Last reviewed: 30 March 2011