Meningococcal infection can cause meningitis (inflammation of the lining of the brain and spinal cord), septicaemia (blood poisoning) or both. It is the commonest bacterial cause of meningitis in the UK. The bacteria, Neisseria meningitidis, normally lives in the back of the throat and nose and around 1 in 10 people carry the bacteria without having the disease. The bacteria is spread through sneezing, coughing and kissing.

Meningococcal infection can occur at any age, but around half of cases are in those under 5 years of age, particularly infants less than 1 year. The second main age group is between 15-19 years of age (around 1 in 4 teenagers carry the bacteria).

Symptoms can develop within hours and can be non-specific. It is particulalry harder to identify the infection in babies. The rash does not always occur. In children and adults symptoms can include:

• Sudden onset of a high fever
• A severe headache
• Dislike of bright lights (photophobia)
• Vomiting
• Painful joints
• Fitting
• Drowsiness that can deteriorate into a coma

IN BABIES THERE MAY ALSO BE:

• High pitched moaning or whimpering
• Blank starring, inactivity, hard to wake up
• Poor feeding
• Neck retraction with arching of the back
• Pale and blotchy complexion

Septicaemia occurs if the bacteria enter the bloodstream. A characteristic rash develops and may start as a cluster of pinprick blood spots under the skin, spreading to form bruises under the skin. The rash can appear anywhere on the body. It can be distinguished from other rashes by the fact that it does not fade when pressed under the bottom of a glass (the tumbler test).

Treatment

The infection is treatable with antibiotics. Prompt treatment is essential as the bacteria spreads rapidly. Fatality occurs in about 10% of cases of meningitis and up to 50% of cases of septicaemia. Around 10% of survivors have a major disability as a consequence of the infection.

Vaccination is now available against the common circulating starins of meningoccocus. At Terrine Travel Clinic, we stock the following vaccines.

Bexsero is the recently developed vaccine against meningococcus group B, which has now been approved by the Joint Committee on Vaccinations and Immunisations and is licensed for use in the UK. The vaccine is effective against around 88% of the UK circulating strains of meningococcus group B and 78% of the European circulating strains.

It can be given from 2 months of age as a three dose schedule. From 6 months, it is a 2 dose schedule with a further dose within 1-2 years depending on age. The duration of protection and further doses has not yet been determined.

It can be given at the same time as other childhood vaccines and the side effect profile is similar to other vaccines.