Meningococcal disease

Infectious Disease

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Meningococcal disease is caused by the bacterium Neisseria meningitidis. It causes a range of serious, life-threatening diseases including septicaemia (blood poisoning) and meningitis. It can affect all age groups, but the rates of disease are highest in children under five years of age, and most cases are seen in babies under one year of age. It is also often seen in young people aged 15 to 19 years of age. Overall, 1 in 20 cases of meningococcal disease result in death; death rates are higher for teenagers and young adults. 1 in 5 survivors have permanent effects such as skin scars, limb amputation(s), hearing loss, seizures and brain damage.

There are thirteen different types of the bacterium. Six of these - types A, B, C, W, X and Y - cause most of the disease cases worldwide. The most common types in the UK are B, C, W and Y. Since the MenC vaccine was introduced in the UK in 1999, there has been a big fall in cases of type C meningococcal disease (MenC). Most of the cases of meningococcal disease in the UK are currently caused by type B disease (MenB). Since 2009, cases of MenW disease have been on the increase in the U

 

Meningitis:

  • is the inflammation of the outer covering of the brain and spinal cord.
  • is very difficult to spot in the early stages.
  • Early symptoms are usually fever, vomiting, headache and feeling unwell, just like in many mild illnesses (but in babies under 3 months old there may be no sign of fever).
  • Other symptoms include high-pitched screaming in babies, being difficult to wake, and tense or bulging soft spot on head.
  • The disease progresses very quickly, and can kill in a matter of hours.

Septicaemia:

  • is a serious form of blood poisoning
  • produces a rash in most cases, which is typically non-blanching (but not always, especially in the early stages)
  • may cause joint and limb pain
  • causes shock
  • can lead to skin scarring or limb amputations

See the Meningitis Research Foundation website for more detailed information on the signs and symptoms of meningitis and septicaemia.

 

Meningococcal disease is spread by prolonged, close contact with an infected person. Between 5% and 11% of adults carry the bacteria harmlessly in their throats without any signs or symptoms of the disease. In teenagers this rate rises to 25%, but the carriage rate is low in infants and young children. The number of cases of meningococcal disease peaks in the winter each year.

It is not fully understood why disease develops in some individuals but not in others. Researchers have identified risk factors including smoking, previous infection with influenza type A, and living in ‘closed’ or ‘semi-closed’ communities, such as university halls of residence or military barracks.

 

In the UK, three types of vaccine are offered to different age groups to protect against different types of meningococcal disease.

1. The Hib/MenC vaccine: this protects against type C meningococcal disease, as well as boosting protection against Hib disease. Babies receive one dose at 12-13 months old.

2. The MenB vaccine: this protects against type B meningococcal disease. Babies receive doses at 2, 4 and 12 months old.

3. The MenACWY vaccine: this boosts protection against MenC disease and also protects against MenA, MenW and MenY disease. This vaccine is given to teenagers and student freshers.

Meningococcal vaccines are also recommended for people with some long-term health conditions who are at greater risk of complications from meningococcal disease. See the vaccine page links above for more information.

 

Meningococcal Septicaemia (MenB) - Charlotte's story

Five year old Charlotte Nott developed septicaemia through type B meningococcal disease infection. Her mother, Jenny Daniels, talks about the impact on Charlotte and the rest of her family.

Charlotte Nott

https://www.youtube.com/embed/4AFUK1CgvTU?wmode=opaque&controls=&rel=0

Click here for an accessible text version of this video

Meningococcal disease - Ashley Lee's story

US student Ashley Lee caught meningococcal disease shortly after starting college. She had not had the vaccine which could have prevented it. Grateful thanks to the US National Meningitis Association and Shot by Shot for permission to use this film.

Ashley Lee's Story - Get Vaccinated Against Meningitis

 

Tom - a student's meningitis story

Tom Newman developed meningococcal disease at university. His life was saved by a friend who recognised the symptoms of meningitis. (This film was made by Meningitis Now .)

A Student's Meningitis Story | Meningitis Now

 

 

Meningococcal disease is most often seen in infants and young children. However, there is a second peak in cases in 15-19 year olds, which is not seen in other infectious diseases. It is not known exactly what causes this. A major study, the UK Meningococcal Carriage Study 4 , is looking to see if there might be a connection with lifestyle factors such as smoking and kissing.

Overall, numbers of cases of meningococcal disease have fallen in the UK in recent years. Following the introduction of the MenC vaccine in 1999, the number of cases caused by the type C disease fell by over 90% in vaccinated groups. It also fell by around 66% in non-vaccinated groups owing to herd immunity, as fewer people were carrying the bacteria in their throats and passing them to others (see graph below). Type C infections have caused only 2 deaths in children and young people under 20 in the last 5 years, compared to 78 deaths in the single year before the vaccine was introduced.

Following the success of the UK's MenC vaccination program, type B infections accounted for about 85% of the cases of meningococcal disease before the MenB vaccine was introduced. A total of around 750 people in the UK (mostly babies and children) were infected by MenB in 2011, and around 50 of these died. The MenB vaccine (introduced in September 2015) is expected to have an impact on numbers of cases of MenB disease. UK research from 2016 shows that the MenB vaccine should help to protect babies against other types of meningococcal infection, including the MenW strain which is on the increase in the UK.

At the moment disease cause by MenW is giving cause for concern in the UK. Cases in England increased from 30 cases in 2011-12 to 225 cases in 2016-17 (cases are counted from July one year to June the next year). There was a slight fall in cases in 2017-18 (193 cases). All cases are thought to be due to a single very aggressive strain of MenW bacteria. No other European country has reported an increase in MenW cases, and the reasons for the rise in UK cases is unknown. In response, the government decided to give the MenACWY vaccine to all teenagers and new university students. This programme started in summer 2015. See more information from Public Health England and our blog post from March 2015.

Oxford Vaccine Group (OVG) has worked on the development of MenB vaccines and run trials into their effectiveness. OVG has also run studies looking at the effectiveness of a vaccine which gives protection against strains A,C,W and Y.

The graph below shows the decline in meningococcal disease in the UK in the last 20 years:

meningococcal disease total cases 1998 2018

 

Page last updated Wednesday, November 28, 2018