Overview of Meningococcal Meningitis

Meningococcal meningitis is a rare but serious bacterial infection. It causes the membranes that cover the brain and spinal cord to become inflamed. Each year, approximately 1,000 people in the U.S. get meningococcal disease, which includes meningitis and septicemia (blood infection).

Meningococcal meningitis can be fatal or cause great harm without prompt treatment; as many as one out of five people who contract the infection have serious complications. According to the Centers for Disease Control, even with antibiotics, 10 to 15% of those infected will die and about 1 in 5 of those who survive are left with long-term disabilities that include deafness, brain damage, neurological problems, and even loss of a limb.

Here's what you need to know about the symptoms of meningococcal meningitis and ways to prevent and treat it.

What Causes Meningococcal Meningitis?

Bacteria and viruses are the two main causes of meningitis. The bacterium Neisseria meningitidis, also called meningococcus, causes meningococcal meningitis. In children and teens, meningococcus is the most common cause of bacterial meningitis. In adults, it is the second most common cause.

Meningococcal bacteria may cause infection in a part of the body -- the skin, gastrointestinal tract, or respiratory tract, for instance. For unknown reasons, the bacteria may then spread through the bloodstream to the nervous system. When it gets there, it causes meningococcal meningitis. Bacteria can also enter the nervous system directly after severe head trauma, surgery, or infection.

Your risk for meningococcal meningitis increases if you are exposed to the bacterium that causes it. Your risk also increases if you've had a recent upper respiratory infection. Babies, children, teens, and the elderly are at greatest risk.

What Are the Symptoms of Meningococcal Meningitis?

Symptoms of meningococcal meningitis may vary from case to case. The more common signs and symptoms include:

• General poor feeling
• Sudden high fever
• Severe, persistent headache
• Neck stiffness
• Nausea or vomiting
• Discomfort in bright lights
• Drowsiness or difficulty awakening
• Joint pain
• Confusion or other mental changes

A reddish or purple skin rash (known as petechiae) is a very important sign to watch for. If it does not turn white when you press a glass against it, the rash may be a sign of bacteremia, or a bacterial infection in the bloodstream. This is a medical emergency.

Other symptoms of meningitis or bacteremia may include:

• Tense or bulging soft spot (in babies)
• High-pitched or moaning cry (in babies)
• Stiff, jerky movements or floppiness (in babies or toddlers)
• Irritability
• Fast breathing
• Lethargy or excessive sleepiness
• Blotchy skin, turning pale or blue
• Shivering, or cold hands and feet
• Seizure

What's the Treatment for Meningococcal Meningitis?

Meningococcal meningitis can cause death or serious complications, such as brain damage, paralysis, gangrene, or deafness. To prevent these problems, it's important to act quickly. Do not wait. Seek immediate medical attention. Go to an emergency room or call 911 if:

• You notice symptoms of meningococcal meningitis.
• Symptoms do not improve with treatment.
• You think you have been exposed to meningococcal meningitis.

Tests can confirm a diagnosis of meningococcal meningitis. The doctor may start antibiotics, such as penicillin or ceftriaxone, by an IV, or intravenous line. You or your child may also need other medication to treat problems related to increased spinal fluid pressure. Doctors sometimes prescribe steroids.

If you or someone you love has come into close contact (via saliva or other oral secretions) with someone who has meningococcal meningitis -- such as at school, day care, work, or home -- it is very important to get antibiotics to prevent infection.

Are There Vaccines for Meningococcal Meningitis?

Meningococcal meningitis is a serious disease -- even with treatment. That's why prevention is a far better approach. The meningococcal vaccine can prevent meningitis infection. In the U.S., three types of meningococcal vaccines are used:

• Meningococcal conjugate vaccine (MCV4) -- One of these vaccines, Menactra, is approved for people ages 9 months to 55. The other, Menveo, is used in those ages 2 through 55.
• Meningococcal polysaccharide vaccine (MPSV4) -- This vaccine was approved in the 1970s and protects against most forms of meningococcal disease. This vaccine used is for people as young as 9 months and older than age 55.
• Serogroup B Meningococcal B (MenB) - There are two MenB vaccines. Trumenba (MenB-FHbp) and Bexsero (MenB-4C). Both are licensed for ages 10-24 but can be used in older patients.

Although they cannot prevent all types of meningococcal disease, both vaccines can prevent many types of the disease. Both are effective in nine out of 10 people. MCV4 tends to give longer protection and is better at preventing transmission of the disease.

Doctors recommend a dose of MCV4, which is given as a shot, for children at age 11, and then a booster shot at age 16. If the first dose is missed, the MCV4 can be administered between ages 13 and 15, followed by a booster dose between ages 16 and 18.

People ages 16-18 who are not high risk should also get a MenB vaccine. The vaccine is also designed for people ages 10-24 who are at high risk. It can be used in older adults.

Other people at risk should also consider getting a vaccine. That includes:

• People who think they've been exposed to meningococcal meningitis
• College students living in dorms
• U.S. military recruits
• Travelers to areas of the world, such as Africa, where meningococcal disease is common
• People with a damaged spleen or with terminal complement component deficiency, which is an immune system disorder
• Lab personnel who are often exposed to the meningococcal bacteria

A second dose is recommended for everyone.

Wait to get vaccinated if you are very ill at the time you're scheduled for the shot. Avoid the vaccine if you:

• Have had a severe allergic reaction to a previous dose
• Have a severe allergy to any vaccine component
• Have ever had Guillain-Barre Syndrome or acute disseminated encephalomyelitis

Mild pain or redness at the injection site is common and should not be a problem. But call your doctor right away if you have a strong reaction to the vaccine. This includes a high fever, weakness, or signs of an allergic reaction, such as trouble breathing, a fast heartbeat, or dizziness.

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