You have probably heard of meningococcal disease, but could you identify the symptoms quickly enough if your child came down with the infection?
As paediatrician Dr Margie Danchin explains, knowing what to look out for could save your child’s life.
Dr Danchin works at the Royal Children’s Hospital in Melbourne, where she sees concerned parents and very sick children every day.
“It’s a rare disease, but it’s very serious and can have devastating consequences,” Dr Danchin tells Mamamia. “And that’s why we want parents to know what to look out for and when to act.”
Meningococcal disease might be rare, but it is on the rise. In Australia in 2014 there were 168 cases and in 2016 there were 252. So far in 2017, there have been 210 cases.
The disease is caused by bacteria that can be carried in the throats and noses of about 10 percent of healthy people, who do not develop symptoms.
As Dr Danchin explains, it’s spread through close contact – saliva or droplets from the nose. Apart from children with certain medical conditions that places them at higher risk, teenagers and children aged under five are most at risk of contracting meningococcal disease.
“If treated early with antibiotics, an infected person can make a full recovery,” she says. “But sadly, 10 percent of cases end in death, while up to 20 percent result in permanent disability, such as loss of limbs or scarring from skin grafts, learning, visual and hearing difficulties.”
That’s why it’s so important to know the symptoms to look out for – and how they might differ based on how the meningococcal bacteria can infect the human body.
There are two ways that this happens: A) Through the bloodstream, or B) Through the lining around the brain and spinal cord.
So here’s what to know about both:
1. If meningococcal takes hold in the bloodstream it causes septicemia, sometimes known as blood poisoning. The symptoms may include:
– High fever with cold hands and feet
– Drowsiness, confusion or disorientation
– Shivering
– Vomiting
– Severe aches and pains in the muscles
– Rapid breathing
– Pin prick red spots progressing to blotches and a more purple bruise-like rash.
The rash most people associate with meningococcal disease may not show up unless the bug is in the bloodstream.
“This is the one we want parents to identify more quickly,” Dr Danchin says. “Where you get that classic rash which can start with small pinprick red dots that can then develop into red blotches and bruises.
“This rash is actually bleeding into the skin. That’s because the bacteria is in the blood stream and it causes damage to the blood vessels and makes the blood vessels leaky and the blood leaks out into the skin.”
Parents need to act fast if they notice this rash, as Dr Danchin warns that a child with the rash present could be dead within hours.
Listen: Sarah Parkyn’s tells the awful tale of her daughter Jazmyn’s diagnosis on This Glorious Mess, Mamamia’s podcast for imperfect parents. (Post continues after audio.)
“The best way to tell the difference between a meningococcal rash and a viral rash is the blanch test. If you press your finger to a red spot and the redness goes away, and you let go and the redness comes back, then it may be viral.”
“If you’ve got bleeding into the skin, then the redness doesn’t go away.”
But as Dr Danchin says, the rash is usually not the first sign that a child is unwell. They first might have flu-like symptoms such as high fever, aches and pains. And then, as the illness progresses, confusion, shivering, chills and cold hands and feet.
Dr Danchin says a rash may be present, but it’s important parents don’t wait for a rash to appear before they seek medical attention.
“If their children and very unwell and they have any symptoms, we don’t want parents to wait for the rash to appear.”
2. If meningococcal disease infects the fluid around the brain or spinal cord it will cause meningitis – an inflammation of the brain or spinal cord membranes. The symptoms may include:
– Severe headache
– Fever
– Painful neck
– Sensitivity to light
– Seizures
Dr Danchin says another reason it’s so important that parents do not wait for a rash to appear is that meningitis does not cause a rash. A child with meningitis could only develop a rash if the bacteria also enters their bloodstream, making them critically sick.
“If it’s meningitis, a child will get a severe headache, a painful neck and then sensitivity to light and then vomiting. If left to progress they can get drowsy and lose consciousness,” she says.
“Everybody thinks of meningococcal disease as that awful rash, when in fact your child can have meningococcal meningitis and be very sick without a rash.”
What to do if you think your child might have meningococcal disease.
Dr Danchin says depending on how unwell your child is, you could take them straight to your GP or straight to the hospital.
“If the child is sick, but they are alert you may want to take them to the doctor and they can be treated with antibiotics, but if the child is drowsy or a rash has developed then you should call an ambulance or go to the emergency department.”
Dr Danchin says because the initial symptoms are similar to that of a nasty virus, parents may be told to take their child home.
“We want to encourage parents, that if they notice their child is worsening, to take them back to hospital.”
How to help prevent it.
Being vigilant with general hygiene (regularly washing hands, not sharing cups) helps, but vaccination is a parent's best defence against meningococcal disease.
The five most common strains of the bacteria - A, B, C, Y and W - each cause the same initial symptoms. The good news is, each of these strains can be vaccinated against.
Currently, the C strain vaccine is the only one on the government's National Immunisation Program and is given to babies at 12 months. However, parents can choose to pay to have their children vaccinated against the other strains, which are now more common.
"A vaccine became available for the B strain in 2014. The reason it's not on the national immunisation program is meningococcal disease is still a rare disease and so deciding to fund the program for all children is debated," Dr Danchin says.
"The third vaccine that's available protects children against A, C, Y and W and it is particularly recommended for children who are medically at risk, under the age of five and for teenagers."
But Dr Danchin advises parents should speak to their GP about meningococcal vaccines for all their children if they wish to protect them, especially teenagers and children under the age.
For more information, visit KnowMeningococcal.com.au.
Have you or someone you know suffered from meningococcal disease? Join the conversation below.
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Parents, make sure to ask your GP about meningococcal disease, and what vaccines your child can get to protect them.
For further information, visit KnowMeningococcal.