The most commonly asked questions about Meningococcal, answered.

This Meningococcal Awareness Week, Meningococcal Australia is urging all parents to be aware and SHARE the facts with family and friends to debunk the misconceptions around meningococcal disease.

Unfortunately we still see between 200 and 250 cases of meningococcal disease every year, and the great majority of these are caused by meningococcal B.

Sadly, it is in children under five years where the incidence of meningococcal disease is highest. Of those who contract the disease, five per cent will lose their lives, and around 20 per cent will have permanent disabilities.

After sharing the stories of Danielle, Kendall and Grant, today we’re bringing you a list of the most common questions asked about this devastating disease. Share them with your friends and family. Because knowledge is power.

1.    What is meningococcal disease and how is it spread to people so young?

Meningococcal disease is an acute bacterial infection.  In Australia there are 5 main strains of the disease – A, B, C, Y and W (previously known as W135).

Meningococcal disease is hard to identify because it can appear in several different forms, depending on which part of the body the bacteria invade. There can be meningitis or septicaemia, or a combination of both. Meningitis is inflammation of the lining of the brain and spinal cord and Septicaemia is blood poisoning, which is the more dangerous and deadly of the two forms.

Meningococcal disease can affect people of all ages, from babies to the elderly and everyone in between.  However babies and children can be at a higher risk due to their less mature immune system and a tendency to put things in their mouth. Teenagers and young adults from 15 to 25 years old can also be considered higher risk due to their socially interactive lifestyles that is more likely to involve intimate activities such as kissing and sharing drinks.  Winter and early spring are also higher risk times of the year as there are many viruses around which can weaken the body’s natural immune system.  It is possible to catch a virus first, followed a few days later by a meningococcal infection, which makes early identification very hard.

2.    What’s the difference between meningococcal disease and meningitis?

Meningitis is inflammation of the lining of the brain and spinal cord.  There are many different forms of meningitis including fungal, viral and bacterial.  Bacterial meningitis is the most serious form of the disease.  Most cases of bacterial meningitis are caused by three species of bacteria: Haemophilus influenzae type b (Hib), Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus).

Meningococcal disease is an acute bacterial infection that can cause death within hours and may appear as meningitis (bacterial form as described above) or septicaemia (blood poisoning).

Meningococcal septicemia is the more deadly type of disease.  Bacteria enter the blood stream and multiply uncontrollably, damaging the walls of the blood vessels and causing bleeding into the skin (the rash).

3.    How does meningococcal disease affect the body and what are the warning signs of infection? Can you get meningococcal disease and never get the rash?

The symptoms of meningococcal disease are detailed below (note the differences in symptoms depending on whether it takes the form of meningitis or septicaemia).

Young children and babies may have less specific symptoms. These may include irritability, difficulty walking or lethargy, refusal to eat and high pitched cry, bulging fonteanelle (soft spot on the top of the head).

The rash – is quite characteristic of the disease. It can start off as a spot, blister or pinpricks – later develops into purple bruise-like blotches.  The rash does not always appear or may appear when it is too late – do not wait for the rash.  Act early.
4.    What distinguishes the symptoms of meningococcal disease as a cold, vomiting and elevated temperatures are quite common in children?

With meningococcal disease, your child will rapidly deteriorate in relatively short period of time (within hours), whereas with a cold or gastro infection they can usually be stabilised.  With meningococcal disease usual dosing of analgesics (such as paracetamol) may not work in reducing their temperature.  Refer to the symptoms for both meningococcal septicemia and bacterial meningitis.  Additional symptoms more specific to babies and young children may include irritability, difficulty walking or lethargy, refusal to eat or drink, a high-pitched cry, and a bulging fonteanelle (soft spot on top of the head).  They can appear limp bodied and have a vacant expression in their eyes.

5.    How much time do you usually have between the early signs of infection and possible fatality? How do you know whether or not to rush to hospital?

If a person does have meningococcal disease, you can have less than a day between the early signs of infection and possible death.  Every hour counts.  If you are not satisfied with a medical practitioner’s diagnosis, get a second opinion.  If symptoms become worse, go back to the doctor to discuss immediate antibiotic treatment as well as urgent blood tests to determine if meningococcal is the cause of illness.

6.    How many strains of meningococcal disease are there, and how many can you be vaccinated for?

In Australia, there are 5 main strains of meningococcal disease, 13 strains worldwide.  Of the 5 main strains in Australia, Meningococcal A, C, Y, and W can be vaccinated against.  Meningococcal B cannot currently be vaccinated against.  However a vaccine for meningococcal B is in the process of being made available, with recent TGA approval of a vaccine for B strain.

There is no single vaccine to cover all strains of meningococcal disease.  In Australia meningococcal C is made available as part of the 12 month immunisation schedule for children.  This was introduced in 2003.  All Australians born before this time who have not had a ‘catch up’ vaccination are at risk of meningococcal C as well as the other strains unless the combination A, C, Y, W vaccine has been received.

7.    How do you prevent meningococcal infection? And what about for those strains there is no vaccine for?

Meningococcal disease is caused by bacteria, which can live harmlessly in our throat and nose. It is spread via mucus through activities such as sneezing, coughing, intimate kissing, and sharing food or drinks.

Good hygiene is important in minimising the likelihood of spreading meningococcal disease.  This includes washing hands, turning away to cough, blowing noses on tissues and disposing of the tissues in the bin and washing hands once again.  Avoid sharing drinks and food.

The bacteria only live for a short time outside the body so even if you pick them up you will not necessarily become ill.  The danger only occurs if you pick up a strain you are not immunised against, or don’t have a natural immunity to, or if you have a weakened immune system.

8.    If your child’s vaccinations are up to date, are they still at risk of contracting meningococcal?

Yes.  Even if your child’s vaccinations are up to date they are still at risk of contracting meningococcal.  This is because there are 5 strains of meningococcal and it is currently only strain C that is vaccinated against as part of the childhood immunisation schedule.

9.    How often do people contract meningococcal after they have been immunised?

There are 5 main strains of meningococcal disease in Australia (13 strains worldwide).  Even if a person has been vaccinated against one strain, they can still contract a different strain of meningococcal.  Currently there are vaccinations available for meningococcal A, C, Y and W.  There is no vaccine available for meningococcal B – however there is one in the process of being made available.

10.    Can you please provide us with more information about meningococcal vaccination? For instance, is it a live vaccination?

Meningococcal is not a live vaccination (weakened version of the disease).  A meningococcal C conjugate vaccine is given to babies at 12 months of age as part of the immunisation schedule.  A conjugate vaccine works to stimulate the immune system to produce antibodies.  These antibodies are what will fight any future meningococcal infection for which a person has been vaccinated against.   A combination vaccine is also available for the strains A, C, Y, W.  For further details consult your family doctor.