Meningococcal Disease (Meningitis) and students
- Meningitis is an inflammation of the lining that covers the brain and spinal cord.
- Bacterial or viral infection is the usual cause.
- Bacterial meningitis is uncommon but serious.
- Viral meningitis is quite common but much less serious.
Meningococcal infection is uncommon, but it is the commonest cause of bacterial
meningitis in the UK.
Meningococcal bacteria are divided into serveral groups:
- Groups B and C. Cases of Group C are now rare in the UK.
Group B is now the usual cause of meningococcal infection in the UK
- Group A infection is the commonest in the world, but tends to be
confined to certain hot countries. It is rare in the UK, but travellers to certain
countries are offered immunisation against Group A.
It can affect anyone at any age. However, children under 5 years are the most at
risk. The second commonest age group at risk are teenagers aged 15, 16 and 17.
- Meningococcal bacteria live harmlessly in the noses and throats of about
1 in 4 people.
- Meningococcal bacteria do not survive outside of the body
- Close contact is needed to pass it on to others such as kissing, coughing or
sneezing near to others
- Rarely, this baterium overcomes the body's immune system and gets
into the blood.
- Most cases of meningococcal infection are islolated cases
- The risk of others catching it are low.
- Sometimes small outbreaks occur when two or more people in the same household
or community are affected.
Sympmtoms
One or more of the following symptoms may occur
Common early warning signs:
Many children who are developing meningitis or septicaemia have non-specific
symptoms such as just feeling or looking generally unwell. However, three symptoms
that commony develop early on are:
- Leg pains, pains can become severe and prevent standing or walking
- Cold hands or feet
- Pale, dusky or blue colour of the skin around the lips
Classic symptoms:
- Neck Stiffness
- Rash, commonly occurs but not always
The rash is red or purple. Small spots develop at first and may occur in groups
anywhere on the body. They often grow to become blotchy and look like little bruises.
One or two may develop at first but many may then appear in different parts of the body.
The spots do not fade when pressed. To check for this do the tumbler test
. Place a clear glass firmy on one of the spots. If the spot does not fade and
you can still see it through the glass get medical help immediately.
Other symptoms that may occur in older children or adults:
- Fever and shivering. (hands and feet often feel cold)
- Stiff neck. (cannont bend the neck forward)
- Headache. (which can become severe)
- Fast breathing
- Aches and pains in muscles or joints
- Pale or blotchy skin
- Dislike of bright lights
- Drowsiness or confusion
- Repeated vomiting
Symptoms usually develop quickly over a few hours. Symptoms can occur in any order
and not all may occur. Sometimes symptoms develop more slowly over a few days. The
symptoms may suggest a less serious illness at first. For example, fever, headaches
and vomiting are common symptoms of many viral illnesses such as flu. Therefore,
even if you think it was flu to start with, if symptoms become worse then it may be
meningitis or septicaemia. It is important to keep checking on friends
who are ill.
Treatment
Antibiotic injections are needed urgently. High doses are usually given.
Intensive care is often also needed at first as the infection often causes shock
and problems thoughout the body.
Prognosis (outlook)
The outlook often depends on how soon antibiotics are given after the illness starts.
Most people make a good recovery if treated early enough. Without treatment most
people will die.
A difficulty is that meningococcal infection can develop very quickly and can mimic other
illnesses when symptoms first begin. Treatment may be delayed if the cause of early
symptoms is not clear at first. In some cases a person can be well in the morning, develop
flu like symptoms by the afternoon, and be critically ill or dead by the evening.
In the UK about 1 in 10 people who have meningococcal meningitis without
septicaemia die. Of those that survive, some are left with some permanent damage such
as brian injury or deafness. If septicaemia occurs then up to half of cases may die
depending on how quickly treatment is given.
Can meningococcal infection be prevented?
Since 1999 babies have been routinely immunised against Group C meningococcus. A different
vaccine may be used for travellers going to Group A meningococcal prone countries.
A vaccine is not yet available against Group B meningococcus which remains the most common
type of meningococcal infection in the UK.
Contacts
Close contacts of a person with meningococcal infection have an increased risk of
developing the illness. However, the risk is still low. Close contacts usually
means household members or intimate kissing contacts within the pervious seven days.
These people are offered a short course of antibiotics to prevent possible infection.
If Group C meningococcus is the cause, then immunisation is also offered to close contacts.
Occasionally an outbreak of two or more cases of meningococcal infection occurs in the same
school, college or similar community. Antibiotics and / or immunisation may then be offered
to a wider group of people.
Further information can be obtained from the following helplines and websites:
The Meningitis Research Foundation.
080 8800 3344 (24 hour helpline)
The
Meningitis Trust
NHS Direct
The Health Protection Agency