What Is Meningococcal Disease?

Neisseria meningitidis is a bacteria that can cause infections in the body. One area this bacteria can infect is the meninges. The meninges is the membrane that surrounds the brain and spinal cord. A bacterial infection of the meninges, called bacterial meningitis, can cause death within hours. Quick diagnosis and treatment are vital.

The disease is usually spread by direct contact with discharge from the mouth or throat of an infected person (eg, kissing). In general, it is not spread by casual contact.

The disease is most common in:

  • Infants aged less than one year
  • People with certain medical conditions (eg, lack of spleen)
  • College freshmen who live in dorms—increased risk

About 2,600 people in the US develop the disease each year. Approximately 10%-15% of these people die. Another 11%-19% lose their arms or legs, become deaf, have nervous system problems, become mentally retarded, or suffer seizures or strokes.

Symptoms of meningitis include:

  • High fever
  • Headache
  • Very stiff, sore neck
  • Red or purple skin rash
  • Cyanosis (bluish skin color)
  • Nausea
  • Vomiting
  • Photophobia (sensitivity to bright lights)
  • Sleepiness
  • Mental confusion

Symptoms in newborn and infants can be hard to distinguish. These may include:

  • Inactivity
  • Unexplained high fever or low body temperature
  • Irritability
  • Vomiting
  • Jaundice
  • Feeding poorly or refusing to eat
  • Tautness or bulging of soft spots between skull bones
  • Difficulty waking

When treatment is provided immediately, more than 90% of all people with the disease survive. Treatment may include:

  • Antibiotics
  • Corticosteroids
  • Fluid replacement

What Is the Meningococcal Vaccine?

There are two meningococcal vaccines available in the US:

  • Meningococcal polysaccharide vaccine (MPSV4)—given as a shot under the skin
  • Meningococcal conjugate vaccine (MCV4)—given as a shot into the muscle

Both are made from parts of the meningococcal bacteria. Neither contains live bacteria.

Who Should Get Vaccinated and When?

The MCV4 vaccine is recommended for all children at their routine pre-adolescent visit (11-12 years of age). In addition, for adolescents entering high school who have never gotten MCV4, a dose is recommended before high school entry. The vaccine is also recommended for people at increased risk for meningococcal disease, including:

  • College freshmen living in dormitories
  • Scientists routinely exposed to meningococcal bacteria
  • US military recruits
  • People traveling to or living in parts of the world where meningococcal disease is common (eg, parts of Africa)
  • People with a damaged or removed spleen
  • People with immune system disorders
  • People who might have been exposed to meningitis during an outbreak

With the MCV4 vaccine, certain high-risk people should be revaccinated, including those who:

  • Have immune system disorders
  • Have a damaged or removed spleen
  • Travel or live in parts of the world where meningococcal disease is common

The timing of revaccination with MCV4 changes with age. High-risk people need another vaccine if:

  • They are aged 2-6 years and received the vaccine three years ago
  • They are aged 7 years and older and received the vaccine five years ago
  • People who remain at high-risk should be vaccinated every five years.

MCV4 is also recommended for high-risk people who received MPSV4 three years ago.

The MCV4 vaccine is preferred for children 2-10 years old who are in a high-risk group. MCV4 is also the preferred vaccine for people aged 11-55 years of age. MPSV4 can be used if MCV4 is not available.

What Are the Risks Associated With the Meningococcal Vaccine?

The meningococcal vaccine, like all vaccines, has the potential to cause serious problems, such as severe allergic reactions. The risk of the vaccine causing serious harm or death is extremely small.

Mild problems associated with the vaccine include redness or pain at the injection site or a fever. Rarely, people who have received the MCV4 vaccine have developed a serious nervous system disorder called Guillain-Barre syndrome.

Who Should Not Get Vaccinated?

If you have the following conditions, you should not get the vaccine:

  • Have had a life-threatening allergic reaction to a previous dose of the vaccine or its components
  • Are moderately or severely ill—Wait until you recover before getting the vaccine.
  • Have ever had Guillain-Barre syndrome—Talk to your doctor.

The vaccines may be given to pregnant women. However, the MCV4 vaccine has not been extensively studied in pregnant women. It should be used only if it is clearly needed.

What Other Ways Can Meningococcal Disease Be Prevented Besides Vaccination?

Preventive antibiotics may be given to people in close contact with an infected person, such as:

  • Healthcare workers
  • Family members

What Happens in the Event of an Outbreak?

In the event of an outbreak, close contacts of infected people and people at increased risk should get the vaccine. Antibiotics may be recommended for people in close contact.