Meningococcal infections are caused by a group of bacteria called Neisseria meningitidis. The most common forms of meningococcal infections include meningitis (infection of the membranes that surround the brain and spinal cord) and blood stream infections. Meningococcal infections are usually uncommon, but potentially fatal.
- The National Foundation of Infectious Diseases estimates 2,800 cases of invasive meningococcal disease in the US each year.
- Meningococcal infections occur most frequently during the late winter and early spring months.
- Meningococcal infections are most prevalent in children, but also occur in adolescents and adults.
The Neisseria meningitidis bacteria are spread through close contact with infected individuals. Droplets in the air from a sneeze or close conversation can be inhaled and may cause infection. Many individuals who acquire the bacteria in their nose and throat never develop symptoms. In rare cases, the bacteria proliferate rapidly causing serious illness in both children and adults.
The following are the most common symptoms of meningococcal infections. However, each child may experience symptoms differently. Symptoms may include:
- meningococcal meningitis - an infection of the membranes that surround the brain and spinal cord.
- in children older than 1 one year, symptoms may include:
- neck and/or back pain
- nausea and vomiting
- neck stiffness
- in infants, symptoms are difficult to pinpoint and may include:
- sleeping all the time
- refusing bottle
- cries when picked up or being held
- inconsolable crying
- bulging fontanelle (soft spot on an infant's head)
- behavior changes
- meningococcemia (blood stream infection) - meningococcemia is a potentially life-threatening illness. Symptoms may occur abruptly and progress rapidly. Immediate intervention and treatment are usually necessary.
While each child may experience symptoms differently, the following are the most common symptoms of meningococcemia:
With rapid progression of the meningococcemia infection, symptoms may include:
- sore throat
- aching muscles and joints
- malaise (not feeling well)
- exhaustion and weariness
- rash, which may appear as follows:
- small, red flat or raised, fine rash
- progression of rash to larger red patches or purple lesions (similar in appearance to large bruises)
- low blood pressure
- very low urine output
- impaired blood clotting that can lead to internal and external bleeding
- infectious shock (a serious state marked by decreased blood pressure and decreased blood flow to important organs such as the kidneys, liver, and brain.)
The symptoms of meningococcal meningitis and meningococcemia may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic studies for meningococcal meningitis and meningococcemia may include:
- lumbar puncture (spinal tap) - a special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes your child's brain and spinal cord.
- blood cultures
- culture of skin lesions or rash
- additional blood work (to evaluate bleeding times and cell counts)
Specific treatment for meningococcal infections will be determined by your child's physician based on:
- your child's age, overall health, and medical history
- extent of the disease
- your child's tolerance for specific medications, procedures, or therapies
- expectations for the course of the disease
- your opinion or preference
Prompt treatment is imperative with meningococcal infections. Antibiotics (i.e., penicillin) are most commonly used. If a child has severe allergies to penicillin, other antibiotics may be used to treat the infection. Five to seven days of antibiotic therapy is usually effective. A child with meningococcal meningitis or meningococcemia may require close observation in a hospital or intensive care unit (ICU).
Other treatment for meningococcal infections is supportive (aimed at treating the symptoms present). A child with severe infection may require supplemental oxygen or mechanical ventilation to assist with breathing. If a child develops severe bleeding, he/she may require blood transfusions.
There is a new meningococcal vaccine (MCV4) that the Centers for Disease Control and Prevention (CDC) currently recommends for adolescents between 11 to 12 and again at 15 years of age, or high school entry, whichever comes first. Others who may require immunization include the following if they are 11 or more years of age:
- asplenic children (children without a spleen)
- college students not already immunized in high school (immunization of college students is recommended by the American College Health Association)
- military recruits
- individuals who are traveling to countries where the incidence of meningococcal infections is higher (parts of Africa)
- family members or those in close contact of individuals with meningitis
A hospitalized child will require isolation for 24 hours after antibiotics have been administered. Family members or individuals that have been in close contact with a child with meningococcal disease may require antibiotics. If you have questions about exposure, please consult your child's physician. The CDC recommends the following contacts be treated if exposed to the bacteria:
- household contacts, especially young children
- child care or nursery school contacts, during previous seven days
- direct exposure to the infected child's secretions through kissing, sharing toothbrushes, or eating utensils
- individuals who frequently sleep in the same area as the infected child
Cases of meningococcal disease should be reported to your local public health department. They will provide education to you and your family, as well as to the public.
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