Meningococcal disease: Information for the public

This page contains information for the public regarding Meningococcal disease

Page last updated: 25 March 2020

There are multiple types of the bacteria that cause invasive meningococcal disease (IMD) which are called serogroups. There are four different meningococcal serogroups that are seen across Australia. There are also other serogroups that occur overseas but are rarely seen in Australia.

What is invasive meningococcal disease?

IMD is an uncommon but very serious infection that occurs when the meningococcal bacteria ‘invades’ the body from the throat or nose. It usually appears as meningitis or sepsis.

‘Meningitis’ means an inflammation of the protective coverings of the brain and spinal cord. ‘Sepsis’ means blood poisoning, which is a more widespread infection throughout the body.

IMD is caused by bacteria called ‘meningococci’. There are a number of different types of meningococci.

How serious is invasive meningococcal disease?

Although IMD is uncommon, it is a very serious disease. The infection can develop very quickly and can be fatal in 5-10 per cent of cases. Most people make a complete recovery if the infection is diagnosed early and antibiotic treatment commenced promptly. The early signs of the disease can look like other milder illnesses, so it is sometimes hard to diagnose early. About a quarter of the people who recover from meningococcal disease experience some after-effects of the infection. Most of these problems get better with time. Some of the more common after-effects include:

  • headaches
  • skin scarring
  • limb deformity
  • deafness in one or both ears
  • tinnitus (ringing in the ears)
  • blurring and double vision
  • aches and stiffness in the joints
  • learning difficulties.

Where do meningococci come from?

Meningococci are common bacteria and around 10-20 per cent of people carry them at the back of the nose and throat without showing any illness or symptoms. Carriers are more often young adults and less often children and older people. Meningococci are only found in people and never in animals or the general environment.

What is a meningococcal ‘carrier’?

Almost all adults and children can carry these bacteria and most will not get sick with IMD. These people, who have the bacteria, but are not affected are known as carriers.

Generally, people become carriers without knowing they have caught the bacteria and will get rid of it naturally, without treatment, after a few weeks or months.

Who catches invasive meningococcal disease?

Some people who catch the bacteria become sick. It is not usually clear why a particular person becomes sick instead of just becoming a carrier.

IMD can occur at any age, but babies and children less than five years of age are most at risk. Teenagers and young adults aged 15–24 years are also at increased risk.

For people who become sick the average time between being infected and becoming ill is about three to five days, but can be up to seven days. Rarely, small outbreaks with more than one person can happen, but usually each case is unrelated to any others.

What are the symptoms?

IMD is an emergency. If you think a person has symptoms that suggest IMD, contact your doctor immediately, call triple zero (000) for an ambulance or go to the nearest hospital emergency department.

Someone with meningococcal disease will become very ill, usually feeling sicker than they have ever felt before. There are many symptoms of meningococcal disease, although a few are especially important. Most cases may show only a few of these symptoms and they hardly ever all happen at once. Signs and symptoms sometimes appear very quickly and people with IMD can get much worse within a few hours.

The symptoms of meningococcal disease may include:

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In infants and young children:

  • fever
  • disinterest in feeding or lack of appetite
  • leg pain, cold legs and hands
  • unusual skin colour
  • irritability / fretfulness
  • extreme tiredness or floppiness
  • dislike of being handled
  • vomiting and / or diarrhoea
  • turning away from light
  • drowsiness
  • convulsions, fits or twitching
  • rash of red-purple pinprick spots or larger bruises.

Young children may not complain of symptoms, so fever, pale or blotchy complexion, vomiting, lethargy (blank staring, floppiness, inactivity, hard to wake, or poor feeding) or rash are important signs.

In older children and adults:

  • headache
  • photophobia (dislike of bright lights)
  • fever
  • leg pain, cold extremities
  • unusual skin colour
  • vomiting and / or diarrhoea
  • neck stiffness or aching
  • backache
  • joint pains, sore muscles, cold hands and leg pain
  • general malaise, off food
  • drowsiness, confusion
  • rash of red-purple pinprick spots or larger bruises.

In meningococcal septicaemia a rash is a very important, but late sign. The rash can appear anywhere on the body and may vary from just one or a few small spots, especially early on, to later covering large areas of the skin. Absence of the rash does not exclude IMD.

You know your family and friends better than anybody else. If somebody close to you has some of these signs and appears to you to be much sicker than usual, seek medical help immediately. Children and young adults should not be left alone if they are sick. Early diagnosis and treatment is vital.

If you are sent home by the doctor or hospital, it is important to return promptly for further assessment if symptoms get worse or do not improve in the time suggested by the doctor.

How is invasive meningococcal disease spread?

The disease is difficult to spread. The bacteria cannot live outside a human body and they cannot be picked up from surfaces, water supplies, swimming pools, buildings, food, drinks, pets or other animals.

Spread of the bacteria is associated with intimate, prolonged and/or close contact.

The bacteria are passed between people in the secretions of fluid from the back of the nose and throat. This generally requires intimate, close and/or prolonged contact with a person carrying the bacteria, who is usually completely well. Meningococcal bacteria are not easily spread by sharing drinks, food or cigarettes.

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If a case of IMD occurs some people are at greater risk of infection than usual, although their overall level of risk remains very low. This includes:

  •  people who live in the same household,
  • sexual and other intimate contacts, and
  • close contacts in residential accommodation, such as student halls of residence and military barracks.

How is invasive meningococcal disease treated?

If a case of IMD is suspected, an antibiotic is given immediately by injection and the patient is admitted to hospital.

Can invasive meningococcal disease be prevented?

Four types of meningococcal bacteria (B, C, W, and Y) account for most cases of IMD in Australia. Vaccines are available in Australia for types A, B, C, W and Y. The Australian Immunisation Handbook, online version provides current guidance on meningococcal immunisation.

Meningococcal ACWY vaccine is provided free through the National Immunisation Program (NIP) for eligible persons.

Information on meningococcal vaccination and on who is eligible for free vaccine through the NIP can be found on the meningococcal immunisation service webpage.

Children and adolescents not eligible for meningococcal vaccines through the NIP may be able to receive free vaccines through state-funded programs. Contact your state or territory health department for details.

Further details of meningococcal immunisation, including vaccine recommendations can be found in the Australian Immunisation Handbook Meningococcal disease chapter.

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What happens when a case occurs?

Public health authorities identify close contacts of the infected person and offer them clearance antibiotics to help prevent further spread of infection. These people are members of the same household, intimate contacts (e.g. boyfriends and girlfriends), and anyone who has spent a lot of time in the same dwelling as the infected person in the seven days before they became unwell. Other contacts, such as friends and work colleagues, do not usually need clearance antibiotics.

Whenever an infection occurs, public health authorities will advise what should be done, and will make sure all close contacts are treated with the right antibiotics to stop the infection spreading.

Antibiotics are given to close contacts to eliminate the bacteria from the throat and prevent the bacteria from being transmitted to others, just in case the contact may be an innocent carrier of the strain that caused illness. Clearance antibiotics are different to the antibiotics used to treat the infection and people who receive clearance antibiotics are still at some risk of developing the disease and therefore need to remain alert for any signs and symptoms.

Once a person has recovered from meningococcal disease they will not be infectious and can safely return to childcare, school, or work. There are no restrictions on contacts of an infected person attending work, school or childcare, whether or not it is recommended that they take clearance antibiotics.

More information

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