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Meningococcal
infection is a serious illness caused by a bacterium known as
meningococcus
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Meningococci
are bacteria found naturally at the back of the throat or nose
in about 10% of the population
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Many
adults and children carry these germs without ill effects
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Many
of the meningococci seem to be harmless and may prevent more
dangerous meningococci getting into the body
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Only
rarely do meningococci cause illness
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When
this occurs, the bacteria 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)
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There
are a number of different groups of meningococci. At present
in the UK around 60-65% of cases are caused by Group B strains.
Group C strains cause illness in around 35-40% of cases and
are more common in older individuals.
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Meningococcal
infection is not highly infectious
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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.
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Close
contact in residential accommodation, such as student halls
of residence, and schools can also give the opportunity for
the spread of infection
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It
is not known why some people become ill while others remain
symptomless carriers of the bacteria
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Infection
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.
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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).
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There
were over 2000 cases reported in the UK in 1998
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Someone with the infection will become very ill, though not all the
symptoms will occur at once:-
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Sudden
onset of a high fever
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A
severe headache
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Dislike
of bright lights (photophobia)
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Vomiting
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Painful
joints
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Fitting
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Drowsiness
that can deteriorate to a coma
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Symptoms are more difficult to identify in young babies but may include:-
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A
fever while the hands and feet are cold
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High
pitched moaning or whimpering
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Blank
starring, inactivity, difficult to wake up
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Poor
feeding
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Neck
retraction with arching of the back
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Pale
and blotchy complexion
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Septicaemia
occurs if the bacterium enter the blood stream. 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)
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Symptoms
can develop within hours
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The
bacteria only rarely give rise to meningococcal disease, in
which case the infection is fatal in 10% of cases (up to 50%
with septicaemia)
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If
infection is diagnosed early and treated promptly most people
make a full recovery
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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.
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The
current vaccine available for group C meningococci does not
protect children under the age of 18 months. Immunity only lasts
for 3-5 years and so the vaccine is most suitable for outbreak
control, rather than for a widespread immunisation programme.
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A
new vaccine against group C meningococcal infection is to be
introduced shortly. Subject to licensing of the vaccine, the
first doses will be given in Autumn of 1999 to the age groups
most at risk (babies and young people). This new vaccine does
not protect against group B meningococcal infection, which accounts
for about 60 % of cases of meningococcal infection.
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There
is no vaccination for group B infection at present and trials
are at a very early stage
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Antibiotics
are recommended for close contacts of a case to prevent further
spread of infection
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If
group C is involved, the vaccine may be given as well as antibiotics
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Specialist
doctors called Consultants in Communicable Disease Control (CCDC)
will be advising what else should be done
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Antibiotics
are used to treat meningococcal disease
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The
earlier the treatment, the better the chances of recovery
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If
meningococcal disease is suspected the doctor should be contacted
immediately. If the doctor is unavailable take the patient to
the nearest accident and emergency department
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The
pneumococcus bacteria usually causes pneumonia but in people
with impaired immunity (such as those who have had their spleen
removed), this bacteria can also cause meningitis
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A
vaccine is available and should be given to all those aged two
years or more in whom infection is likely to be more common
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Meningitis
due to Haemophilus influenzae used to be a major problem
in young children. Since the introduction of the Hib vaccine
into the routine immunisation programme, the incidence of Haemophilus
meningitis has fallen dramatically.
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Viral
meningitis is a milder disease. For most forms of viral meningitis
the risk of transmission and period of infectiousness are not
known.
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If
you’re unsure about anything don’t be afraid to ask your pharmacist
or health visitor for further advice. |
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