The Facts about Meningococcal Disease

Meningococcal disease refers to two conditions cause by the bacterium Neisseria meningitidis. Meningococcal meningitis is an inflammation of the meninges, the tissues that cover the brain and spinal cord. Meningococcemia is an infection of the blood with Neisseria meningitidis.

Symptoms
The signs and symptoms of meningococcal disease can vary widely. Fever, headache, vomiting, stiff neck and a rash are common signs and symptoms of meningococcal meningitis. People with meningococcemia often develop a fever, rash, headache and weakness. A person may have either meningococcal meningitis or meningococcemia, or both at the same time.

The symptoms may develop rapidly, sometimes in a matter of hours, but usually over several days. In some cases, death may occur within hours of the onset of symptoms. The symptoms may appear anytime between 2 and 10 days after exposure, usually within 3 to 4 days.

Anyone can get meningococcal disease, but it is more common in children and young adults. Compared to other persons their age, college freshmen, especially those who live in dormitories, are at modestly increased risk for meningococcal disease. Most people exposed to Neisseria meningitides do not become seriously ill.

Transmission
The meningococcus bacterium is spread by direct, close contact with respiratory and oral secretions (saliva, sputum or nasal mucus) of an infected person. Close contacts include household members, day care center contacts and anyone directly exposed to the patient's oral or nasal secretions. Many people carry this bacterium in their nose and throat without any signs of illness, while others may develop serious symptoms.

A person may transmit the disease from the time he/she is first infected until the bacteria are no longer present in discharges from the nose and throat. The duration varies according to treatment used. Patients should be excluded from school, daycare or the work place until at least 24 hours after therapy was begun and the illness has subsided.

Treatment
Penicillin is the drug of choice for meningococcal disease, while third generation cephalosporins are reasonable alternatives.

People who have been in close contact with a person who has been diagnosed with meningococcal disease should be considered for preventive treatment. Close contacts include household members, intimate contacts, persons performing mouth to mouth resuscitation or endotracheal intubation, day care center contacts, or anyone directly exposed to the patient's oral or nasal secretions. Such people are usually advised to take preventive antibiotics, such as rifampin, ciprofloxacin or ceftriaxone.

Close contacts (family, daycare, nursery school, etc.) should be alerted to watch for early signs of illness, especially fever, and seek treatment promptly.

Casual contact that might occur in a regular classroom, office or work setting is not usually significant enough to cause concern.

Prevention
Presently, there are vaccines that will protect against many types of meningococcal disease.

The meningococcal vaccine is recommended in some outbreak situations or for travel to areas of the world where high rates of the disease are known to occur. Epidemics of meningococcal meningitis occur frequently during the dry season (December through June) across sub-Saharan Africa. Vaccination is usually required by the government of Saudi Arabia for those embarking on the annual Hajj pilgrimage to Mecca.

For more information on this topic, see the HealthLink articles The Facts about Meningitis and The Facts about Meningitis and Meningococcal Disease.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.