Meningococcal disease
Key Findings
The disease
Meningococcal disease is caused by the bacterium Neisseria meningitidis, also known as meningococcus. There are 13 types of meningococcus, of which the most common in Australia are B, W, Y and C. Meningococcal disease is rare but serious. It usually presents as meningitis (inflammation of the membranes covering the brain and spinal cord) or septicaemia (infection in the bloodstream). Death occurs in 5–10% of cases.
Transmission
Meningococci are common bacteria and around 10% of people carry them at the back of the nose and throat without any signs or symptoms. Spread generally requires prolonged close contact. It is not clear why some people get sick while others do not, but it's important to remember that a person doesn’t have to have symptoms to spread the bacteria.
Signs and symptoms
People with meningococcal disease can become very sick within a few hours.
Symptoms may include:
- sudden fever
- headache
- neck stiffness
- joint pain
- a typical rash of red-purple spots
- dislike of bright lights
- nausea and vomiting.
Young children and infants can have:
- fever
- irritability
- drowsiness or difficulty waking up
- high-pitched crying
- lack of appetite.
Vaccination recommendations and coverage
The meningococcal ACWY (MenACWY) vaccine is funded under the National Immunisation Program for all children at 12 months of age and for adolescents at 14–16 years of age and is delivered through school-based vaccination programs. Because of the higher risk of disease, both MenACWY and meningococcal B vaccines are recommended for all Aboriginal and/or Torres Strait Islander people aged 2 months to 19 years.
Who is most affected?
Meningococcal disease can occur at any age, but it is more common in children under 5 years of age and adolescents.
How common is it?
Between 2016 and 2019, there were 1120 notifications of invasive meningococcal disease, with 170 (15.2%) of these reported in Aboriginal and/or Torres Strait Islander people.
Overall notification rates in Aboriginal and/or Torres Strait Islander people were 3.5 times higher than for other people. They were 9.7 times higher for children aged less than 5 years and 20 times higher for children aged 5–14 years.
Rates of meningococcal disease notifications were 84% higher in Aboriginal and/or Torres Strait Islander people in this reporting period than in the previous reporting period, compared to 20% higher for other Australians.
Hospitalisations/deaths
There are certain difficulties related to interpreting meningococcal hospitalisation rates. Due to this, and because almost all cases of meningococcal disease will need hospitalisation, notification rates are generally accepted as the more accurate measure of disease.
During the 2016–2019 period, overall hospitalisation rates among Aboriginal and/or Torres Strait Islander people were 3.2 times higher than for other Australians. They were 7.5 times higher in children aged 0–4 years and 13 times higher in children aged 5–14 years.
There were 67 deaths reported during the 2016–2019 period where meningococcal disease was recorded as the underlying or associated cause of death, with 11 (16%) of these occurring in Aboriginal and/or Torres Strait Islander people.
Vaccination prior to being exposed to meningococcal is best.