Meningococcal Disease

Four-month-old female with gangrene of hands due to meningococcemia

What is Meningococcal Disease?
Meningococcal disease is a serious illness caused by the Neisseria meningitidis bacterium, also called meningococcus. The two most severe and common forms of meningococcal disease are meningitis and septicemia. Meningitis is an infection of the fluid and lining around the brain and spinal cord, which can lead to brain damage, hearing loss, learning disabilities, and even death. Septicemia is a bloodstream infection, which can lead to loss of an arm or leg and possibly death.

The bacterium are spread through the exchange of nose and throat droplets, such as when coughing, sneezing or kissing. Symptoms of the disease may develop over several hours or over 1 to 2 days, and may include sudden onset of fever, stiff neck, severe headache, nausea, vomiting, sensitivity to light, and confusion or difficulty concentrating.

Anyone can contract meningococcal disease but it is most common in infants less than one year of age, in adolescents 16-21 years of age, and in people with certain medical conditions, such as the lack of a spleen. College freshmen who live in dormitories have an increased risk of getting meningococcal disease.

According to a July 7, 2017 article published in the CDC's MMWR, research suggests that patients receiving eculizumab (Soliris®) are also at high risk for meningococcal disease despite vaccination.

The Statistics
About 1,000 people get meningococcal disease each year in the United States. Even if they get treatment, about 1 in 10 people with meningococcal disease will die from it. Of those who survive, 1 in 5 will suffer permanent disabilities, such as brain damage, hearing loss, loss of kidney function or limb amputations.

The Vaccine
The meningococcal conjugate vaccine (MCV4) protects against many types of meningococcal disease. Children between 2 months and 10 years old with certain high-risk conditions should receive the meningococcal conjugate vaccine However, the number of doses of vaccine depends upon the specific high-risk condition.

Adolescents should be vaccinated with two doses of meningococcal conjugate vaccine, which protects against serogroups A, C, W, and Y. The first dose is given at 11 or 12 years of age. The second dose is given at 16 years of age. First-year college students up through age 21 years who are living in residence halls should be vaccinated if they have not received a dose on or after their 16th birthday. Military recruits should also be vaccinated before they move into military barracks.

One or more doses of meningococcal vaccine are needed for adults with certain medical conditions or risk factors.

Recently, two new serotype B meningococcal vaccines (MenB) were approved by the FDA. The ACIP recommends that certain people 10 years of age and older who are at increased risk for meningococcal disease receive MenB vaccine. Additionally, MenB vaccines may also be given to anyone 16 through 23 years old to provide short-term protection against most strains of serogroup B meningococcal diseases. Ages 16 through 18 years are the preferred ages for vaccination.

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