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Meningococcal disease is an uncommon but life threatening infection. The meningococcal bacteria (Neisseria meningitidis) are a significant cause of disease in Australia, especially in the very young, teenagers, young adults and those with medical risk factors.
The meningococcal bacteria can cause meningitis (inflammation of the meninges, the membrane lining of the brain and spinal cord) and/or septicaemia (blood poisoning).
There are thirteen different types or serogroups of meningococcal bacteria including Meningococcal Groups B, C, W135, A, Y and others, the most common in Australia being meningococcal group B and C.
Although the risk is low, meningococcal disease can affect anyone, anywhere, at any age and may be devastating for patients and their families.
Meningococcal meningitis and septicaemia tends to be more common during winter and early spring.
Babies and young children (less than 5 years), and young adults (15-24 years) are most at risk from meningococcal disease.
Smoking (both active and passive) and overcrowded conditions may be associated with increased risk of developing meningococcal infection, as is a recent viral infection.
The bacteria that cause meningococcal meningitis and septicaemia commonly live in the nose and throat of about 10% of the population, with higher rates in teenagers and young adults. The vast majority of people “carry” the bacteria in their nose and throat without developing any illness. People of any age can carry the bacteria for days, weeks or months without becoming ill. In fact, being a carrier helps to boost natural immunity.
Meningococcal bacteria can spread from person to person via airborne droplets that are expelled from the lungs and throat during the breathing cycle or whilst coughing. The bacteria cannot survive more than a minute or two outside the body, so they can’t be picked up from environmental surfaces, food or water. Close prolonged contact, such as living in the same household with someone who is carrying the bacteria, is usually required to transmit the bacteria from one person to another.
Only on rare occasions do the bacteria overcome the body’s defences and invade the body causing life-threatening disease. Some people develop meningococcal meningitis or septicaemia soon after “picking up” the bacteria. The meningococcal bacteria penetrate the membrane lining the nose and throat, avoid the body’s immune system and multiply and travel in the blood stream to the brain or other organs. It is unclear why meningococcal bacteria can invade some people’s bloodstream and not others, but it is likely that their immune system does not recognise and respond to these bacteria adequately.
Someone with meningitis will become very ill. The illness may progress over one or two days, but it can also develop very rapidly, sometimes in a matter of hours. Most cases of meningitis start with a high fever, severe headache and neck stiffness (however this is an uncommon symptom in young children). Vomiting and drowsiness often follow. The person may complain of discomfort when looking at bright lights (however this is also an uncommon symptom in young children). In some cases a rash may appear.
If you suspect meningitis, seek urgent medical advice. Do not wait for a rash to appear.
- Headache
- Fever
- Vomiting
- Neck stiffness and/or joint pains
- Drowsiness or confusion
- Rash – may vary in appearance, however may be a rash of pink, red-purple spots or bruises*
- Discomfort when looking at bright lights or light sensitivity
- Fitting or convulsions
*In both children and adults there may be a rash of tiny, pink/red/purple spots or bruises, which does not usually fade under pressure and is caused by bleeding into the skin, (However this is not always a dependable test). This can occur anywhere on the body and is due to blood poisoning (septicaemia), which sometimes occurs together with meningitis.
- Fever possibly with cold hands and feet
- Refusing feeds or vomiting
- Dislike of being handled and/or cries when moved
- Fretful or irritable behaviour
- Child is difficult to wake / lethargic or limp
- High-pitched moaning cry or whimpering
- Pale or blotchy complexion
- Neck retraction with arching of back
- Blank staring expression
- Convulsions or fitting or jerking body movements
- Rash - may vary in appearance, however may be a rash of pink or red-purple spots or may have a bruise like appearance*
The symptoms of meningococcal disease do not need to occur in any order and may not all be present. Babies become ill very quickly.
If you are concerned about someone’s health, or suspect they may have meningitis and/or septicaemia seek urgent medical attention. If your GP or hospital has reassured you, do not hesitate to return to the GP or hospital immediately if the symptoms worsen or you are still concenred.
For more signs and symptom information visit Meningitis signs and symptoms
Some of the bacteria that cause meningitis can also cause septicaemia (or blood poisoning).
Some people may develop meningitis or septicaemia or both. If both meningitis and septicaemia occur at the same time a person may have some symptoms of meningitis and some of septicaemia.
- Fever (possibly with cold hands and feet)
- Chills
- Pain in legs or arms
- Unusual skin colour or pale complexion
- Pain in abdomen or chest
- Diarrhoea
- Nausea or vomiting
- Sore muscles or joints
- Drowsiness or lethargy (however many people may be quite alert until late in the development of the disease.)
- Confusion
- Behaviour changes – may be irritable or restless
- Rash (the rash can start anywhere on the body. The rash can vary in appearance and not every person who has septicaemia, will have a rash. The rash can start as a pink rash, a pink, purple or red spot. It can also appear as red, purple or brownish coloured pin prick spots, which may develop, into a bruise like rash. The rash does not usually fade when pressed, (However this is not always a dependable test).
If you think someone has a septicaemic rash seek urgent medical attention.
- Fever (possibly with cold hands and feet)
- Refusing feeds or vomiting
- High pitched moaning cry or whimpering
- Dislike of being handled or fretful behaviour
- Blank staring expression
- Child is difficult to wake or lethargic
- Pale blotchy complexion
- A rash - If you think a baby has a septicaemic rash seek urgent medical attention.
- Diarrhoea
- Floppy or stiff body or jerking body movements
- Breathing problems or increased rate of breathing
The symptoms of meningococcal disease do not need to occur in any order and may not all be present. Babies become ill very quickly.
For more signs and symptoms information visit Septicaemia signs and symptoms
If you think a baby, child or adult is ill or you are concerned about their health, or that they may have meningitis and/or septicaemia seek medical attention and advice urgently. Be persistent and don’t be afraid to go straight back to the hospital or doctor if the person deteriorates or you are still concerned.
Sometimes people can have meningitis alone, septicaemia alone or both at the same time. If both meningitis and septicaemia occur at the same time a person may have some symptoms of meningitis and some of septicaemia.
As the meningococcal bacteria are transmitted through close contact, very close family and other intimate contacts (eg girlfriend, boyfriend) of the patient are at an increased risk of contracting the disease.
However, even if a person has been in close contact with someone who has developed meningococcal disease, the risk of developing the disease is low.
Household contacts (or people who have been in very close contact with a person who developed the disease) are at an increased risk of contracting a meningococcal infection and are routinely offered antibiotics to kill any meningococcal bacteria that they may be carrying in their nose and throat, or might have picked up from the infected patient. The antibiotics reduce, but cannot eliminate, the risk of family members or other high-risk contacts, also becoming ill. Because of this, if contacts who have received antibiotics become unwell or exhibit some of the symptoms of meningitis or septicaemia, it is vital they also seek urgent medical attention.
Public health doctors are urgently notified of each case of meningococcal disease and conduct a ‘contact trace’. The ‘contact trace’ is conducted to identify people who have been in ‘high risk contact’ with a person who has meningococcal disease, within the seven days prior to onset of the disease. High-risk contacts are usually people who have been living in the same household as the person who developed the disease or who had close contact with the patient. Where a case of meningococcal disease involves a patient who attends a childcare group, or school class, individual in depth assessments of the particular circumstances are made. Usually, other contacts such as school friends and workmates are normally not at any significant risk and generally do not need special treatment with antibiotics or investigation. However any doubts should be discussed with the Department of Health.
People who are identified as high-risk contacts are offered preventative or prophylactic antibiotics. The antibiotics will not stop a person developing the disease if the infection has already started. Consequently, people receiving preventative antibiotics still need to be vigilant for and informed of the signs and symptoms of meningococcal disease. The greatest risk period for contacts developing infection is in the first 2 weeks after their contact with the patient. Rarely, contacts may develop infection some weeks afterwards. If they are concerned about their health they should seek immediate medical attention and say they have been in contact with meningococcal disease.
The incubation period (the time it takes to develop the first symptoms of a disease from when a person was first exposed to an organism) for meningococcal disease is usually between two and ten days.
Diagnosis of meningococcal disease is made by undertaking certain medical tests. This may include taking samples of blood or cerebrospinal fluid (the fluid that circulates around the brain and spinal cord) to try and isolate the bacteria.
Meningococcal infections are always treated with antibiotics. Close contacts receiving preventative antibiotics usually take these orally.
People who have meningitis and/or septicaemia, are normally treated in hospital with intravenous antibiotics (antibiotics given into the vein of a patient) and they may also require other supportive medical intervention. Alternative medical therapies such as herbal or naturopathic treatments are ineffective in treating life threatening meningococcal infection.
A number of vaccines are available against some of the strains of meningococcal bacteria. Please see vaccine information section.
Most people who have meningococcal meningitis survive and a large number make a good recovery. However some people are left with permanent after effects from the disease, such as brain damage or long term disabilities such as deafness, epilepsy, visual impairment, behaviour problems or learning difficulties. Further information about possible after effects may be accessed from the ‘after effects' section of the website.
In 2003 there were 536 notifications of meningococcal disease (including meningitis or septicaemia or both) in Australia. (Communicable Diseases Australia – National Notifiable Diseases Surveillance System 2004 http//www1.health.gov.au/cda/Source/Rpt_4.cfm)
Information on the number of cases of meningococcal disease in each state and territory can also be accessed from the Communicable Diseases Australia site.
The Meningitis Centre is a 'not for profit' support organisation based in Australia, not a professional medical authority. Consequently the text on this web site provides general information about meningitis and septicaemia, not medical advice and is not intended for use in the diagnosis or treatment of the diseases. Please consult your doctor to discuss the information or if you are concerned someone may be ill.
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