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
- Very stiff, sore neck
- Red or purple skin rash
- Cyanosis (bluish skin color)
- Photophobia (sensitivity to bright lights)
- Mental confusion
Symptoms in newborn and infants can be hard to distinguish. These may include:
- Unexplained high fever or low body temperature
- 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:
- 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.
WHERE CAN I GET MORE INFORMATION?
American Academy of Pediatrics
National Immunization Program
Centers for Disease Control and Prevention
Bacterial meningitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated April 2009. Accessed August 8, 2009.
Meningitis. Immunization Action Coalition website. Available at: http://www.immunize.org/vis/. Accessed February 6, 2007.
Meningitis questions and answers. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/meningitis/about/faq.html. Updated June 2009. Accessed October 2, 2009.
Meningococcal disease. DermNet NZ website. Available at: http://dermnetnz.org/bacterial/meningococcal-disease.html. Updated June 2009. Accessed October 2, 2009.
Meningococcal disease. Wisconsin Department of Health Services website. Available at: http://dhs.wisconsin.gov/communicable/FactSheets/Meningococcal.htm. Updated November 2008. Accessed October 2, 2009.
Meningococcal vaccination. US Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/vaccines/vpd-vac/mening/default.htm. Accessed February 6, 2007.
Vaccine information statements. Immunization Action Coalition website. Available at: http://www.immunize.org/vis/. Accessed February 6, 2007.
1/31/2008 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Centers for Disease Control and Prevention. Recommended immunization schedules for persons aged 0-18 years—United States, 2008. MMWR. 2008;57;Q1-Q4. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm. Updated January 10, 2008. Accessed January 28, 2008.
10/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php: Centers for Disease Control and Prevention. Updated recommendation from the Advisory Committee on Immunization Practices (ACIP) for revaccination of persons at prolonged increased risk for meningococcal disease. MMWR. 2009;58(37):1042-1043. Centers for Disease Control and Prevention, MMWR website. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a4.htm. Published September 25, 2009. Accessed October 2, 2009.
Last reviewed November 2009 by ]]>David L. Horn, MD, FACP]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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