Meningococcal disease

Meningococci can cause serious illnesses, particularly among infants, small children and adolescents and among those at higher risk of infection or of developing complications. Vaccination is recommended for all such groups.

Pathogen and transmission
Pathology
Distribution and frequency of occurrence
Prevention

Pathogen and transmission

Invasive meningococcal disease is caused by various serotypes of the Neisseria meningitidis bacterium (also known as meningococcus). Some 8 to15 per cent of Europe’s population have meningococci in their nose and throat area without falling ill. Infection is caused by close contact with a healthy carrier or with a person already infected, and the bacteria are transmitted by droplets, e.g. through direct coughing or kissing.

Pathology

An infection with meningococcus bacteria which is limited to the nose and throat area is essentially harmless and will not lead to symptoms. If the bacteria get into the blood or other organs via the mucous membranes (invasive illness), however, this can lead to more serious conditions such as blood poisoning (known as meningococcaemia) or meningitis. Meningococcaemia symptoms may develop swiftly in the form of fever, chills, aching limbs, fatigue and often a skin rash. In its most dangerous form it can lead within hours to shock, coma and death. Meningococcal meningitis produces flu-like symptoms along with seizures, mental confusion and stiffness of the neck. Even if treatment is initiated early in the form of antibiotics, long-term effects such as hearing loss, seizures and paralysis may persist. The mortality rate with such complications is around 7 per cent. So should any of the above symptoms develop, it is extremely important to see a doctor or find a hospital without delay.

Distribution and frequency of occurrence

Invasive meningococcal disease occurs all over the world, though sub-Saharan Africa (which is known as the ‘Meningitis Belt’) has particularly high case numbers. Switzerland sees around 50 cases of severe meningococcal disease a year. Most of these are children under five or adolescents aged between 15 and 19.

Prevention

Vaccination against invasive meningococcal disease is recommended for children aged between 3 and 18 months (to whom a catch-up vaccination may be administered up to the 5th birthday), for adolescents aged between 11 and 15 (to whom a catch-up vaccination may be administered up to the 20th birthday) and for persons of any age with certain immunocompromising conditions (congenital or drug-induced deficiencies), military recruits, certain laboratory personnel and travellers to certain risk areas.

No single vaccine of those presently available covers all the serogroups that can cause invasive meningococcal disease. Different vaccines against invasive meningococcal disease are available to cover the various serogroups.

A vaccination against invasive meningococcal disease caused by serogroup B and a quadrivalent vaccine against serogroups A, C, W and Y are presently recommended. According to the latest data, these two vaccinations cover the majority of the serogroups which are responsible for cases of invasive meningococcal disease in Switzerland.

Which serogroups are primarily responsible for invasive meningococcal diseases may change over time. Such trends are carefully monitored by the relevant authorities, and the corresponding vaccination recommendations are modified as and when required.

To prevent illness through close contact with a person with invasive meningococcal disease, a doctor may also prescribe prophylactic antibiotic medication for and/or appropriately vaccinate the close contact(s) concerned.

For further information on the global distribution of invasive meningococcal disease and measures to prevent disease, consult your GP or a doctor specialising in travel medicine (see the register under ‘Links’ below).