Meningococcal Disease
Meningococcus (Neisseria meningitis)
Meningococcus bacteria cause several different infections besides meningitis. They can cause different forms of blood poisoning: septicemia, which is severe, and meningococcemia, a milder form, also pneumonia, arthritis, and infections of the heart, eye, or other parts of the body.
Meningitis is the most common form of Meningococcal infection, about 75%. Septicemia is the next common – 20% – and the other infections make up the balance. Both are medical emergencies and require immediate medical attention. Septicemia is more dire. Less than one in twenty people die of Meningococcal meningitis. Eight in twenty die of septicemia. If shock – low blood pressure and blood circulation failure – occurs before treatment can be started, the death rate from meningococcal septicemia is more than twelve in twenty, or 60%.
Both infections are rare, however. 10 to 20 per cent of adolescents and adults carry the meningococcus bacteria in the back of their noses and throats without any noticeable effects. These carrier infections may last up to six months. Only one or two in 100,000 have severe meningococcal infections. 250 to 750 cases occur each year in Canada, usually between December and April. Children under 5 are most susceptible. The next most common group to be infected is teens and adults from 15 to 24 years. After the age of 20, most people have developed a natural immunity and are no longer at risk.
Symptoms begin mildly – like a cold or flu with fever, headache, aches and pains in joints and muscles. They progress rapidly into much more severe effects. It is important to note that meningococcal septicemia and meningitis share some symptoms but there are significant differences.
A person with meningococcal septicemia will not likely have a headache, stiff neck, or neck pain. Septicemia infections almost always result in a rash; meningitis infection will sometimes cause a rash but not always. The rash may appear anywhere on the body and may not develop until the disease is quite advanced. It is the most specific and most noticeable symptom of Meningococcal septicemia, primarily because it does not fade under pressure.
To check for meningococcal rash, press the side of a colorless glass against the rash. If the redness does not fade with the pressure, the rash is likely meningococcal. Note that the redness may fade under pressure when the rash first appears, so it is wise to do the glass test more than once.
| Meningococcal infection symptoms | Meningitis | Septicemia |
| Fever, usually high | yes | yes |
| Cold hands and feet | yes | yes |
| Drowsiness, impaired consciousness | yes | yes |
| Irritability, fussiness, agitation | yes | yes |
| Severe headache | yes | yes |
| Vomiting | yes | yes |
| Stiff neck | yes | no |
| Pain on moving neck | yes | no |
| Rash | not always | yes |
| Rapid breathing | rarely | yes |
| Pain in muscles, joints, abdomen | rarely | yes |
| An early rash | A more advanced stage |
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Meningococcal bacteria spread through direct contact with secretions from the nose and throat. Because the bacteria are fragile outside the body, spread from an infected carrier to another person requires close, direct physical contact through kissing, coughing or sneezing. They also spread through saliva. Sharing anything that comes in contact with the mouth can spread the bacteria from person to person – mouthpieces on musical instruments, drinking glasses, lipstick, eating utensils, toys and such can all spread the bacteria.
A sick person can spread the disease up to seven days before becoming ill and for one day after antibiotic treatment begins. Usually, however, infection is the result of contact with a healthy carrier rather than someone who is sick with meningococcal disease.
Treatment is with antibiotics, usually penicillin. Other antibiotics may be given to protect individuals who have had contact with a case of meningococcal disease. There are effective vaccines to protect against some kinds of meningococcal disease.
For more information about preventive treatment of close contacts, click here.
