Meningococcal disease is caused by a bacterium called Neisseria meningitidis (“meningococcus”). Although meningococcal disease is uncommon, it can be very serious. The infection can develop very quickly and may be fatal. If infection is diagnosed early enough and appropriate antibiotics are given quickly, most people make a complete recovery.

Meningococci live naturally in the back of the nose and throat in about 10-30% of people without causing illness. People of any age can “carry” the bacteria without becoming ill. Although everyone is probably a carrier at some time, carriers are most common among young adults.

In a small number of people, a particular strain of meningococcus manages to get through the lining of the throat, enter the bloodstream, and cause “invasive” meningococcal disease such as meningitis.

Meningococcal disease is uncommon, but it is serious.

• Most cases occur “out of the blue” (i.e., they are “sporadic”) and are unrelated to any others. Outbreaks (”epidemics”) where more than one person is affected are rare.
• Every year in the United States approximately 2,500 people are infected and 300 die from the disease.

What types of illness does meningococcus cause?

• Meningitis (an infection of the membranes covering the brain and spinal cord)
• Septicemia (an infection in the bloodstream)
• Other body organs or parts may be affected by “seeding” of bacteria from the bloodstream.

How are the bacteria spread?

• Meningococcal bacteria are difficult to spread. They are only passed from person to person by regular, close, prolonged household and intimate contact with secretions from the back of the nose and throat of an infected person.
• Meningococci are only found in humans and cannot live for more than a few minutes outside the body. You cannot catch the bacteria from the environment (e.g., door knobs, computer keyboards, or telephones) or animals.

Who is at risk for meningococcal disease?

• Anyone can get meningococcal disease, but it is more common in infants and children. However, for some adolescents, such as first year college students living in dormitories, there is an increased risk of meningococcal disease. Other persons at increased risk include household contacts of a person infected with meningococcus, persons who are immunocompromised, and people traveling to parts of the world where meningococcal meningitis is prevalent.

What times of the year present the greatest risk?

• Cases can occur all year round; however, they are more common during winter and early spring.

What are the signs and symptoms?

• Fever, headache, and neck stiffness (the classic symptom triad of meningitis)
• Discomfort when looking at bright lights (photophobia)
• Loss of appetite
• Nausea and/or vomiting
• Diarrhea
• Acing or sore muscles
• Painful or swollen joints
• Difficulty walking
• General malaise (a general feeling of illness without specific symptoms)
• Moaning, unintelligible speech
• Drowsiness
• Confusion
• Collapse
• Skin rash consisting of red-purple pinprick spots or larger bruises (See photographs)
• The skin rash of a meningococcal bloodstream infection is typically “non-blanching.” This means that, unlike many other skin rashes, it does not temporarily disappear when pressure is applied (e.g., with a finger).
• One way to check for a non-blanching skin rash is to press a glass against the rash and see if it fails to lessen or disappear with pressure (See drawing).

How soon does one become ill after exposure?

• The symptoms typically appear within 2-10 days of exposure to an infected person, most commonly within 5 days.

What is the treatment for meningococcal disease?

• If meningococcal disease is suspected, an antibiotic is given immediately. People with meningococcal disease are almost always admitted to the hospital and may require admission to an Intensive Care Unit.
• Early treatment is vital. The sooner that antibiotic and other treatments begin, the less damage the disease will cause. However, this is a very serious infection which can progress rapidly despite the best treatment.

Who is at risk for contracting meningococcal disease from an infected person?

• Only people who have been in close contact with an infected individual are at significantly increased risk of becoming ill themselves. Casual contact, as might occur in a regular classroom or office, is not usually significant enough to cause concern.
• Close contacts include:
• Members of the same household and roommates (e.g., in dormitories)
• Intimate contacts such as a girlfriend or boyfriend or anyone directly exposed to the patient's nasal or oral secretions
• Airline travelers who have had direct contact with respiratory secretions from a patient, or anyone sitting directly next to a patient on a prolonged flight (i.e., one lasting = 8 hours).
• Certain healthcare personnel
• Day care center children and staff

What should one do if he or she is a “close contact” of an infected individual?

• Close contacts are typically treated with a short course of antibiotics as soon as possible (ideally within 24 hours after exposure to an infected individual).
• Such prophylactic (protective) antibiotic regimens are effective at removing meningococci from the nose and throat, but they are not an effective treatment for meningococcal disease. Anyone with symptoms of meningococcal disease should immediately see a physician or go to a hospital Emergency Department for appropriate diagnosis and treatment.

Vaccines

• The CDC recommends the use of a vaccine called Menactra to reduce the risk of meningococcal disease in people 11-55 years of age.
• Menactra is formally recommended by the CDC for first year college students living in dormitories, but it is of benefit to all teenagers and young adults in the United States .
• Neither Menactra nor any other vaccine can provide complete protection against meningococcal disease, especially insofar as some strains of the bacteria are not included in the vaccine. In addition, other bacteria and viruses can cause meningitis and blood infections, and Menactra provides no protection against these infectious agents.
• The Northwestern University Health Service has meningococcal vaccines available.

When in doubt, seek medical assistance

• You know yourself and your friends better than anybody else. If you think that you or someone you know has symptoms that suggest meningococcal disease, contact a physician immediately or go the nearest hospital Emergency Department. Early diagnosis and treatment are vital..
• In the very early stages, meningococcal disease can appear to be like other, less serious illnesses. Your doctor may not immediately recognize this illness. If you become sicker, do not hesitate to seek medical help again—even if it has only been an hour or two since you last sought help.
• Anyone suspected of meningococcal disease should not be left alone as they may become very sick very rapidly.

Questions?

• Contact the University Health Service for questions .