What every parent should know about Meningococcal Disease

When it comes to our children, we pray that they will get through their early years without any serious illnesses. We hope that a disease-free childhood will enable them to grow up to lead healthy and happy lives.

One of the ways that we can protect our children from childhood diseases – rare or common – is to be aware of what they are, how to recognise their symptoms and know the preventive measures against them.

In this article we look at meningococcal disease – a rare but devastating disease, which can progress so rapidly that often there is no time for a proper diagnosis and treatment.^1,2,3 In fact, Invasive Meningococcal Disease can kill within 24 hours. ^1,2,4 In such cases, one way of protecting your child against it, is through vaccination.

Read on to learn more about the causes, symptoms and measures to protect against meningococcal disease.

What is meningococcal disease?

Meningococcal disease is caused by the bacterium Neisseria meningitidis, also called meningococcus.⁴

About 1 in 10 people carry these bacteria at the back of their nose and throat without them ever causing disease.⁴ However, in a small number of people, a dangerous strain of the bacteria can move through the lining of the throat and enter other parts of the body, causing what is known as invasive meningococcal disease.⁴

The two common manifestations of Meningococcal Disease are²:

1. Meningitis which results from the infection of the lining of the brain and spinal cord. When someone has meningococcal meningitis, the protective membranes covering their brain and spinal cord, known as the meninges, become infected and swell.^2,3
2. Septicemia which results from bloodstream infections. When Neisseria meningitidis bacteria enter the bloodstream and multiply, they damage the walls of the blood vessels and cause bleeding into the skin and organs.³

Both these forms of meningococcal disease are rapidly progressive – leaving little time for diagnosis and treatment — and can kill or disable within 24 hours.^1,2 They should always be viewed as a medical emergency.⁴

10-15 percent of meningococcal disease cases result in death.⁴ Up to 1 out of 5 cases who recover can experience long-term disabilities, such as loss of limbs, deafness, nervous system problems, or brain damage.^2,4

Meningococcal disease can appear in all age groups.³ It is not well understood why only a few people develop invasive illness, but this may be influenced by genetic, immune (e.g., preceding viral illness), societal (e.g., smoke exposure) or physical factors making them more susceptible to disease.³

How does it spread?

Neisseria meningitidis are spread from person to person through:

1. Respiratory droplets through coughing and sneezing¹
2. Close and intimate contact such as kissing via throat secretions (saliva or spit)¹

It can also spread through the sharing of food or drinking from a shared container. Immediate family members and other persons sharing a household are considered at risk.² Do note, that it is not spread through casual contact.²

How do you recognise the symptoms of meningococcal disease? What are the treatments and preventive measures for it? Click on the next page to find out.

Recognising the symptoms

While there are some common symptoms such onset of fever and excessive fatigue, that indicate the onset of meningococcal disease, both meningitis and septicemia present their own set of distinct symptoms.

Symptoms of meningitis^2,4

The symptoms of meningococcal meningitis can appear quickly or over several days. Typically, they develop within 3-7 days after exposure and include sudden onset of fever, headache, and stiff neck. There are often additional symptoms, such as:

1. Nausea
2. Vomiting
3. Photophobia (increased sensitivity to light)
4. Altered mental status (confusion)

In newborns and infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to notice, what you should look out for instead is if the baby appears to be: slow or inactive, irritable, vomiting or feeding poorly.

In young children, doctors may also look at the child’s reflexes, which can also be a sign of meningitis.

Symptoms of septicemia^2,4

Septicemia is the more dangerous and deadly form of meningococcal infection. The symptoms include:

1. Fatigue
2. Vomiting
3. Cold hands and feet
4. Cold chills
5. Severe aches or pain in the muscles, joints, chest or abdomen (belly)
6. Rapid breathing
7. Diarrhea
8. A pinprick or purple bruise-like rash in later stages

Treatment

You should get urgent medical advice from your doctor or hospital if you are in any way concerned that you or someone you know is presenting symptoms consistent with meningococcal disease.

Early diagnosis of meningococcal disease is extremely important to minimize the high risk of death.^1,2

If meningococcal disease is suspected, samples of blood or cerebrospinal fluid (fluid near the spinal cord) are collected and sent to the laboratory for testing.⁴ If diagnosed in time, meningococcal disease can be treated effectively with the right antibiotics.^3,5

However, despite its occurrence being rare, meningococcal disease is unpredictable and can be extremely devastating. And because it can progress so rapidly – leaving no time for diagnosis — treatment is not always an option.

Prevention is better than cure

If you have come into direct contact with an infected person, you will usually be advised to take antibiotics for protection and to prevent further spread of infections.³

Also, given meningococcal disease is caused by a bacteria transmitted by respiratory droplets, good hygiene is important to minimising the likelihood of contraction.

However, keeping up to date with recommended immunizations is an effective and recommended way of defending against meningococcal disease.³

In Singapore there are different types of vaccines available to prevent meningococcal disease in infants and children through to adults.

Talk to your doctor about available vaccines and other ways to protect against Meningococcal disease.

References:

1. Thompson MJ, et al. Clinical recognition of meningococcal disease in children and adolescents. Lancet 2006;367:397-403.

2. Centres for Disease Control and Prevention, USA. Meningococcal Disease. Available at https://www.cdc.gov/meningococcal/about/ .Last accessed Feb 2016

3. Changi General Hospital; Meningococcal disease; available at https://www.cgh.com.sg/Health_Library/Health_Information/Pages/HealthLibraryDetails.aspx?DID=155. Last accessed Feb 2016

4. World Health Organization. About Meningococcal Disease. Available at www.who.int/mediacentre/factsheets/fs141/en/. Last accessed Feb 2016.

5. Rosenstein NE, et al. Meningococcal disease. N Engl J Med 2001;344(18):1378-88.