Meningococcal Disease Fact Sheet (meningococcal meningitis, meningococcemia) What is meningococcal disease? Meningococcal (mĕ-ning′gō-kok′ăl) disease includes meningococcal meningitis and meningococcemia (mĕ-ning′gō-kok-sē′mē-ă). Meningitis is an inflammation of the meninges (mĕ-nin′-jēz), the tissues that cover the brain and spinal cord. Meningococcal meningitis is a severe form of meningitis caused by the bacterium Neisseria meningitidis. Meningococcemia is an infection of the blood with Neisseria meningitidis. What are the symptoms? The signs and symptoms of meningococcal disease can vary widely. Fever, headache, vomiting, stiff neck and a rash are common signs and symptoms of meningococcal meningitis. People with meningococcemia often develop a fever, rash, headache and weakness. A person may have either meningococcal meningitis or meningococcemia, or both at the same time. How soon do the symptoms appear? The symptoms may develop rapidly, sometimes in a matter of hours, but usually over several days. In some cases, death may occur within hours of the onset of symptoms. The symptoms may appear anytime between 2 and 10 days after exposure, usually within 3 to 4 days. Who gets meningococcal disease? Most people exposed to Neisseria meningitidis do not become seriously ill. Anyone can get meningococcal disease, but it is more common in children and young adults. Compared to other persons their age, college freshmen, especially those who live in dormitories, are at modestly increased risk for meningococcal disease. How is the bacteria that causes meningococcal disease spread? The meningococcus bacterium is spread by direct, close contact with respiratory tract droplets (saliva, sputum) of an infected person. Close contacts include household members, day care center contacts and anyone directly exposed to the patient’s oral secretions. It is normal for some people to carry this bacterium in their upper respiratory tract without any signs of illness, while others may develop serious symptoms. When and for how long is an infected person able to spread the disease? A person may transmit the disease from the time he/she is first infected until the bacteria are no longer present in discharges from the upper respiratory tract. The duration varies according to treatment used. Patients should be excluded from school, daycare or the work place until at least 24 hours after therapy was begun and the illness has subsided. What is the treatment for meningococcal disease? Penicillin is the drug of choice for meningococcal disease, while third generation cephalosporins are reasonable alternatives. Should people who have been in contact with a person with a diagnosed case of meningococcal disease be treated?
Identification of contacts is important to determine those requiring chemoprophylaxis (preventive therapy). The American Academy of Pediatrics (AAP) and Ohio Department of Health provide the following recommendations: High Risk (close contact): chemoprophylaxis recommended
• Household contact: especially young children
• Child care or nursery school contact during 7 days before onset of illness
• Direct exposure to index patient’s secretions through kissing or through sharing
toothbrushes or eating utensils (eg, markers of close social contact during 7 days before onset of illness)
• Mouth-to-mouth resuscitation, unprotected contact during endotracheal intubation during
• Frequently slept or ate in the same dwelling as index patient during 7 days before onset
Low Risk: chemoprophylaxis not recommended
• Casual contact: no history of direct exposure to index patient’s oral secretions (eg,
• Indirect contact: only contact is with a high-risk contact, no direct contact with the index
• Health care professionals without direct exposure to patient’s oral secretions
In outbreak or cluster
• Chemoprophylaxis for people other than those at high risk should be administered only
after consultation with the local public health authorities
Source: AAP Red Book, 26th edition Is there a vaccine to prevent meningococcal disease? Presently, there is a vaccine that will protect against four of the serogroups of meningococcus. It is recommended in some outbreak situations or for travel to areas of the world where high rates of the disease are known to occur. College freshman should consider receiving the vaccine to decrease their risk of acquiring the disease. ***Contact your local health department if you have additional questions about Meningococcal Disease or vaccine availability*** Cuyahoga County Public Health 216 201-2091 Cleveland City Health Department 216 664-2324 Lakewood City Health Department 216 529-6685 Shaker Hts City Health Department 216 491-1480 This fact sheet was adapted from the Wisconsin Department of Health and Family Services Disease Fact Sheet Series
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