Nothing struck more fear into me as a mother than my babies having a rash. The first thing that would spring to mind was meningococcal disease and I would be doing the glass test (pushing the side of a drinking glass on skin to see if the rash fades) repeatedly to ensure it was ok.
The scariest thing about meningococcal is how symptoms can seem innocuous but can quickly escalate.
The news of a meningococcal case in the local media still makes me nervous and I often wonder if this fear is founded or if I’m over reacting. My babies were vaccinated, but I worry if that is enough.
Here are some facts:
What is meningococcal and how is it spread?
Meningococcal is an acute bacterial infection, not a virus as commonly thought. It can present as meningitis (inflammation of the lining of the brain and spinal cord) or septicaemia (blood poisoning) or both. Septicaemia is the more dangerous and deadly as the bacteria is in the bloodstream and multiples quickly. This is the form that causes the rash.
Both forms are transmitted by bacteria that live in our throat and nose. You can have meningococcal bacteria and not be sick.
The bacteria is transmitted by activities such as sneezing, coughing, kissing or sharing food and drinks. The disease does not live for long outside the body.
What are the symptoms?
It takes between one and 10 days (commonly three-four days) for symptoms of meningococcal meningitis to show after infection.
- severe headache
- stiff or painful neck
- sensitivity to light
- twitching or convulsions
- fevers with cold extremities
- cold shivers
- muscular and joint pain
- pale or blotchy skin
- rapid breathing
- rash – which may start off as a spot, scratch mark or blister, as a faint pink rash or as red or purple pinpricks on the skin, then develop into the distinctive purple bruising
Both strains may cause:
- nausea or vomiting
- sore throat
Additional signs in babies include:
- bulging fontanelle
- highpitched cry
- difficulty feeding
- blank expression
- arching body
NB: A rash signifies a critical stage in the disease. Do not wait for a rash if other symptoms are present such as a consistent high fever.
How is it treated and what is the prognosis?
Meningococcal is a very serious disease. It can develop very quickly and, in some cases (5-10%), be fatal. Treatment with antibotics as soon as possible ensures the best prognosis. However, even with treatment there can be lasting effects from the disease, including:
- 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
How common is it and who is at risk?
There are 13 different types or strains of bacteria that cause the disease. Some have become quite rare due to vaccines. The most common strains globally are A, B, C, W and Y.
In 2017, 337 cases of meningococcal were reported in Australia. This is an increase from 2016, 252 cases and the highest since 2005 (390 cases). This can be attributed to outbreaks of the W strain, particularly in remote aboriginal communities.
People who are immune-compromised are at higher risk, including babies (0-5yo) and the elderly.
Teenagers and young adults (15-24yo) are also considered high risk due to their social lifestyles, which are likely to involve high-risk activities such as kissing and sharing drinks.
What are the vaccines?
Meningococcal C vaccine is part of the routine childhood National Immunisation Program at 12 months of age. You can also ask your GP for older children and adults.
Meningococcal B is available by private script from your GP and is not subsidised by the Government (apart from South Australia). Charges will vary depending on pharmacist.
Meningococcal ACYW (4vMenCV) will be included on the National Immunisation Program from mid-2018 for babies at 12 months of age. This vaccine is also being rolled out across high schools around the country targeting grades 11-12 in response to recent outbreaks. This vaccine is also available from GPs on request (charges will vary depending on pharmacist).
NB: Vaccines do not cause meningococcal disease but may cause fever. It is also possible to become infected after immunisation as no vaccine is 100% failsafe. It is important to seek medical advice when making decisions about immunisation.