The Devastating Impact of Meningococcal Meningitis



Meningococcal meningitis and septicemia is a rare but potentially devastating bacterial infection that affects the brain (meningitis) and/or the blood (septicemia or blood poisoning). Despite advances in medical care, the disease can kill in a matter of hours. One in 10 people who develop the disease will die from it and up to 10-20% of survivors suffer from serious complications such as amputation, scars, deafness or brain damage.2,3

World Meningitis Day 2019 #After Meningitis

By courtesy of CoMO, the Confederation of Meningitis Organisations

Everyone is at Risk 

While meningococcal meningitis mainly affects children below the age of five, adolescents and young adults, it is a highly unpredictable disease that can affect anyone, anywhere in the world, at any age, including a relatively large number of cases among older adults.4 Most meningococcal meningitis occurs in healthy individuals without identifiable risk factors.

How the Disease Spreads 

About one in 10 people (one in four adolescents) has meningococcal bacteria in the back of their nose or throat with no signs or symptoms of the disease; this is known as being “a carrier”.5 But the bacteria may invade the body and cause infections. 

Fortunately, meningococcal disease is not as easily transmitted as other infections such as influenza or the common cold, but the infection is far deadlier.6 It is spread through respiratory droplets, and direct contact with someone who is infected through, e.g. coughing, sneezing or kissing. 

Increased risk factors include: 

  • Living in community settings (e.g. college students’ dormitories) or participating in mass gathering events such as the Hajj, an annual Islamic pilgrimage to Mecca7
  • Certain medical conditions, including HIV infection / asplenia or absence of normal spleen function / a compromised immune system8
  • Travelling to endemic areas such as the meningitis belt in sub-Saharan Africa9

How is it Treated? 

Fast diagnosis and treatment with appropriate antibiotics is imperative as death can occur as rapidly as within 24 hours from the onset of the disease.10,11 As a precaution, people who have been in close contact with anyone infected with meningococcal disease should also receive antibiotics to help protect against an infection.12

Symptoms and Diagnosis   

  • The early symptoms can be misleading as they are often similar to those of flu, e.g. irritability, fever, loss of appetite,13 making diagnosis difficult.14 It’s important to react quickly as the disease can be fatal in less than 24 hours.15
  • Classic signs of meningococcal meningitis include fever, headache and stiff neck. Other symptoms include nausea, vomiting, photophobia (being sensitive to light) and confusion.16
  • To diagnose meningococcal meningitis, samples of blood or cerebrospinal fluid are tested for the Neisseria meningitis bacterium, which causes the disease.17

Prevention Through Vaccination 

There are many different types of bacteria that can cause meningococcal meningitis, the most common being A, B, C, W, Y and more recently, X in Africa.18 Their circulation worldwide is highly unpredictable and varies over time and across age groups and geographies.19 An example of the unpredictable nature of meningococcal meningitis is the recent spread of a virulent W type which caused outbreaks across the UK and several other European countries, South Africa, Brazil, Argentina, Chile and Australia.20

There is no universal vaccine that helps to protect against meningococcal meningitis, however, to date, five (ABCWY) of the most common bacterial types are vaccine preventable.21 Vaccines against meningococcal diseases include quadrivalent vaccines to offer protection against 4 types (ACWY) with one single vaccine, and monovalent vaccines to protect against A, B or C types.22

However, despite the unpredictability and severity of the disease and the benefits of vaccination for all age groups, the low incidence of the disease means routine immunization programs tend to focus on the populations with higher risk of meningococcal meningitis such as infants / toddlers, adolescents, immunocompromised individuals, people in mass gathering or community setting situations such as pilgrims and the military.23 No program to date, however, covers the elderly population despite a proven increased rate of infection in those over 65.24


Click to read the infographic


Click to read the infographic

References

  1. Meningitis Research Foundation. What are meningitis and septicaemia. Accessed March 2019.
  2. CDC. Meningococcal disease – Diagnosis, Treatment, and Complications. Accessed February 2019.
  3. Meningitis now. After-effects of septicaemia. Accessed February 2019.
  4. Martinón-Torres, F. Deciphering the Burden of Meningococcal Disease: Conventional and Under-recognized Elements. Journal of Adolescent Health 59. Volume 59, Issue 1, March 2016. Pages 12-20.
  5. WHO. Meningococcal meningitis. Accessed March 2019.
  6. WHO. Meningococcal meningitis. Accessed March 2019.
  7. CDC. Meningococcal disease – Medical conditions risk factors. Accessed February 2019.
  8. CDC. Meningococcal disease – Medical conditions risk factors. Accessed February 2019.
  9. CDC. Meningococcal disease – Medical conditions risk factors. Accessed February 2019.
  10. CDC. Meningococcal disease – Diagnosis, Treatment, and Complications. Accessed March 2019.
  11. Branco, R., Amoretti, C. and Tasker, R. Meningococcal disease and meningitis. Jornal de Pediatria. Volume 83, Issue 7, 2011. Pages 46-53.
  12. CDC. Meningococcal Disease – Prevention. Accessed March 2018.
  13. CDC. Meningococcal disease – Signs and Symptoms. Accessed March 2019.
  14. CDC. Meningococcal disease – Diagnosis, Treatment, and Complications. Accessed March 2019.
  15. Branco, R., Amoretti, C. and Tasker, R. Meningococcal disease and meningitis. Jornal de Pediatria. Volume 83, Issue 7, 2011. Pages 46-53.
  16. CDC. Meningococcal disease – Signs and Symptoms. Accessed March 2019.
  17. CDC. Meningococcal disease – Diagnosis, Treatment, and Complications. Accessed March 2019.
  18. Crum-Cianflone, N. and Sullivan, E. Meningococcal Vaccinations. Infectious Diseases and Therapy. Volume 5, Issue 2, 2016. Pages 89-112.
  19. Meningitis Research Foundation. What are meningitis and septicaemia. Accessed March 2019.
  20. Mustapha, M., Marsh, J. and Harrison, L. Global epidemiology of capsular group W meningococcal disease (1970–2015): Multifocal emergence and persistence of hypervirulent sequence type (ST)-11 clonal complex. Vaccine. Volume 34, Issue 13, 2016. Pages 1515-1523.
  21. WHO. Meningococcal meningitis. Accessed March 2019.
  22. WHO. Meningococcal meningitis. Accessed March 2019.
  23. Healthy Children.org. Meningococcal ACWY Vaccines: What you Need to Know (VIS). Accessed February 2019.
  24. Australian Government Department of Health. Invasive Meningococcal Disease National Surveillance Report.17 February 2017; Accessed March 2019.