Meningococcal infections are caused by a bacteria called Neisseria meningitidis. The most common forms of meningococcal infections include meningitis (infection of the membranes that surround the brain and spinal cord) and meningococcemia (blood stream infections). Meningococcal infections are uncommon, but can be fatal. These infections occur most often during the late winter and early spring months. Children are more commonly affected, but the illness also occurs in adolescents and adults. College freshman living in dorms are also at risk.
The Neisseria meningitidis bacteria are spread through close contact with an infected person. Droplets in the air from a sneeze or close conversation can be inhaled and may cause infection. Many people who acquire and carry the bacteria in their nose and throat never develop symptoms. In rare cases, the bacteria multiply rapidly, causing serious illness in both children and adults.
While, each child may experience symptoms differently, these are the most common:
In children older than 1 year, symptoms may include:
Neck and/or back pain
Nausea and vomiting
A purple-red, splotchy rash or skin discoloration may appear as the disease progresses
In infants, symptoms are difficult to pinpoint and may include:
Listlessness and sleeping all the time
Refusing a bottle
Crying when picked up or being held
Can't be comforted while crying
Bulging fontanel (soft spot on an infant's head)
Meningococcemia. Meningococcemia is a potentially life-threatening illness. Symptoms may occur suddenly and get worse quickly. Immediate treatment is necessary.While each child may experience symptoms differently, the following are the most common symptoms:
Headache, especially when flexing the neck by moving the chin toward the chest
Sensitivity to light
Aching muscles and joints
Malaise (not feeling well)
Exhaustion and weariness
Rash, which may appear as follows:
Small, red, flat or raised spots
Progression of rash to larger red patches or purple lesions (similar in appearance to large bruises)
As the illness worsens quickly, symptoms may include:
Low blood pressure
Very low urine output
Shock, a serious state marked by decreased blood pressure and decreased blood flow to important organs such as the kidneys, liver, and brain
The symptoms of meningococcal meningitis and meningococcemia may look like other conditions or medical problems. Always consult your child's doctor for a diagnosis.
In addition to a complete medical history and physical exam, other tests may include:
Lumbar puncture (spinal tap). A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection. CSF is the fluid that bathes your child's brain and spinal cord.
Culture of skin lesions or rash (not common)
Other blood tests
Your child's doctor will consider your child's age, overall health, and other factors when advising treatment. Prompt treatment is needed with meningococcal infections. Antibiotics (for example, penicillin) are most commonly used. If a child has severe allergies to penicillin, other antibiotics may be used to treat the infection. Five to seven days of antibiotic therapy is usually effective. A child with meningococcal meningitis or meningococcemia will usually require IV antibiotics and close observation in a hospital or intensive care unit (ICU).
Other treatment for meningococcal infections is supportive (aimed at treating the symptoms present). A child with severe infection may require supplemental oxygen or be put on a ventilator to assist with breathing.
The meningococcal vaccine, meningococcal conjugate vaccine (MCV4), is recommended by the Centers for Disease Control and Prevention (CDC) for all children 11 to 18 years old. Dosages of MCV4 are recommended for children between 11 and 12 years of age and again at 16 to18 years of age. If the vaccine was not given at age 11 to 12, it should be given when beginning high school, with a booster dose a few years later. High-risk infants and young children can receive meningococcal vaccines beginning at age 2 months. Other high-risk children and adolescents who require immunization with MCV4 include the following:
People who have damaged spleens or who do not have spleens
College students not already immunized in high school (immunization of college students is recommended by the American College Health Association)
People who are traveling to countries where the meningococcal infections are common
Family members or those in close contact with people with meningitis
People with a weak immune system
A hospitalized child will require isolation for 24 hours after antibiotics have been started. Family members or people who have been in close contact with a child with meningococcal disease may require antibiotics. If you have questions about exposure, please consult your child's doctor. The CDC recommends the following contacts be treated if exposed to the bacteria:
Household contacts, especially young children
Child care or nursery school contacts, during previous seven days
Direct exposure to the infected child's body fluids through kissing or sharing toothbrushes or eating utensils
People who frequently sleep in the same area as the infected child
Cases of meningococcal disease should be reported to your local public health department. Staff will provide education to you and your family, as well as to the public.