What You Need to Know About: Meningococcal Meningitis

Q. What is meningitis? 
A. Meningitis, often referred to as spinal meningitis by the general public, is an infection of the layers of tissue which cover the brain and spinal cord and causes swelling. It may be caused by many different germs including the bacteria Neisseria meningitidis. It is generally a very serious illness which can result in blindness, deafness, amputations, permanent brain damage, or even death. However, with proper treatment, many people recover fully.

Q. What is meningococcal meningitis? 
A. Meningococcal meningitis is a particularly severe form of meningitis caused by the bacteria Neisseria meningitidis. Even when treated with the right antibiotics, about 10-20% of people with this illness die, often within hours of the onset of the first signs of illness. 

Q. Is meningococcal meningitis contagious? 
A. Yes. However, it is not as contagious as the common cold or the flu. People do not catch them through casual contact or by breathing air where someone with meningococcal disease has been.

Q. How is meningococcal bacteria spread? 
A. It is spread by direct contact, as in coughing, sneezing, kissing, and immediate sharing of unwashed eating utensils. 

Q. What are the symptoms of meningococcal meningitis? 
A.  For adults, symptoms of meningitis may include:

• Fever 
• Severe headache 
• Stiffness of the neck
• Nausea and maybe vomiting
• A skin rash that looks like small, purplish red spots

Any infant with a fever of 101^oF or greater and who is not easily wakened should be seen by a doctor.

Persons with meningitis may also be confused or very drowsy; sometimes they may even go into a coma from which they cannot be awakened. Getting early medical advice when a person has fever, stiff neck and headache, especially when meningitis has been reported in the community, can be lifesaving. 

Q. What should I do if someone in my household gets symptoms of meningitis? 
A. Do not wait. Seek immediate medical attention for the sick person. Remember to ask the doctor about care of household members. 

Q. How is it treated? 
A. Persons with meningococcal meningitis must be hospitalized, almost always in intensive care. They are treated with intravenous antibiotics and other medications, and monitored closely. 

Q. Who is most likely to get sick with meningococcal meningitis? 
A. Up to 15-20% of normal healthy people can have the meningococcal germs in their nose and throat, and remain well. Why some people suddenly become ill with this germ is not understood and happens unpredictably. 
Two groups of people are known to have a higher chance of getting sick, as a result of direct and close contact to the infected case: 

• The first group is people who live together under the same roof where there is a case of meningitis in the house 
• The second group is preschool age children in day care centers where there is a case of meningitis 

Generally, children in the same school have no increased risk of getting sick and should just be observed. The same is also true of adults who work together. 

In a hospital setting, the only people who may have an increased chance of getting meningococcal meningitis are those who have direct face-to-face contact with a case, such as may occur during artificial breathing. 

Q. What if I am exposed to someone who has meningococcal meningitis? 
A. Those who are close contacts (household members, day-care classmates and teachers, and "best friends") will usually be advised to take a two-day course of antibiotics to reduce their risk of meningitis. Depending on the antibiotic used, this may be a single dose or up to two days of medication. Medications used are ciprofloxacin (Cipro) or rifampin given orally, or ceftriaxone (Rocephin) given as an injection. 

Q. How long would it take for me to become sick if I were in close contact with and infected person? 
A. In most situations, there is little chance that an individual who is exposed to a case of meningococcal meningitis will also get sick. However, anybody who has been around a case of meningitis should be alert to the possibility of disease in themselves, and seek medical care if they develop symptoms of meningitis. If you are going to become ill, the symptoms will show up in just a few days. Most people will get sick in two to ten days; the average is three to four days. 

Q. Is there a vaccine for meningococcal meningitis? 
A. Yes. Vaccination with available meningococcal vaccines offers longer-term protection and is routinely recommended for adolescents and others at increased risk. 

There are two types of vaccinations for meningococcal disease available in the US. Meningococcal conjugate vaccines (Menactra® and Menveo®) available in the US provide protection against 4 of the 5 most common serogroups of N. meningitidis (serogroups A, C, W, and Y). Serogroup B vaccines (Trumenba® and Bexsero®) provides protection for the other most common serogroup, serogroup B. Meningococcal vaccinations are generally recommended for those beginning at 11-12 years of age with a booster between 16-18 years of age; however, for those persons at an increased risk for meningococcal disease the age recommended is different.

Depending on the brand and your age you may receive different number of doses. Approximately 2 weeks are required following vaccination for the development of protective antibody levels.

Q. What does the health department do when cases are reported? 
A. The health department investigates every proven or suspected case of meningococcal meningitis that is reported. 

First of all, the health department makes sure that close contacts are treated with preventive antibiotics, and that casual contacts are alerted to the signs and symptoms of disease. The health department also collects information on the particular type of Neisseria meningitidis that causes each illness. If the same particular type is seen in several cases, the health department sometimes recommends immunization of some or all persons in the community. Although there is not strong scientific evidence that mass immunization can stop a community epidemic of meningitis, it is probably worthwhile when a high rate of disease occurs in a community. 

Q. Should I keep my children out of school? Should ball games or concerts be canceled? 
A. The Texas Department of State Health Services and the Centers for Disease Control and Prevention do not recommend restricting travel, school or church attendance, or group events such as sporting or cultural events when meningitis occurs in the community. The risk is very small in those settings since transmission of the bacteria requires rather close exposure. 

Q. Are there other general recommendations to avoid this and other infections in my household? 
A. Personal hygiene is very important. This includes: 

• Covering your nose and mouth when sneezing or coughing
• Frequent handwashing 
• Not allowing people to kiss your baby on the mouth 
• Not sharing common eating utensils
• Avoiding overcrowded conditions