Key points to remember
- meningococcal disease is a bacterial infection
- it causes severe illness
- babies and children with meningococcal disease can get sick very quickly
- meningococcal disease can be difficult to diagnose in its early stages
- check babies or children often when they are sick
- take your child to a doctor urgently if they appear very ill, especially if there is a rash
- take your child back to your doctor urgently if they get worse
- know about the early symptoms of meningococcal disease and teach teenagers about these too
- know where to seek help after hours and how to get there
- early treatment can save lives
- your child can still get meningococcal disease, even if they received the MeNZB™ vaccine during the vaccination campaign 2004 - 2006
What is meningococcal disease?
Meningococcal disease is an infection caused by a bacteria, and can lead to 2 very serious illnesses:
- meningitis (an infection of membranes that cover the brain)
- septicaemia (a serious infection in the blood)
There are several different types of meningococcal bacteria including A, B, C, Y and W135.
- most cases in New Zealand are caused by group B (over 50 percent of confirmed cases in 2013)
- the next most common is group C (30 percent of confirmed cases in 2013)
- there have previously been limited outbreaks of meningococcal disease due to group A
- cases of meningococcal disease caused by groups W135 and Y are rare in New Zealand
How common is meningococcal disease?
There were 64 cases of meningococcal disease in New Zealand in 2015, 46 in 2014 and 68 in 2013. These are the lowest rates of meningococcal disease in New Zealand in over 20 years.
It’s more common in winter and spring. The highest rates of meningococcal disease occur in children aged under 5 years and young people aged 15 - 19 years, but people of any age can be affected.
How is meningococcal disease spread?
Meningococcal disease can easily be passed from one person to another.
The bacteria can be spread through close contact such as:
- living in the same household
- coughing and sneezing
- kissing, sharing food and drink
Why do only some people exposed to meningococcal bacteria get sick?
At any one time, some people will carry meningococcal bacteria in their nose and throat without getting sick.
It is not known why some people who come into contact with meningococcal bacteria get sick and others don’t.
Who is most at risk of catching meningococcal disease?
- meningococcal disease can affect anyone, but those under 20 years of age are at greatest risk
- rates of the disease among Māori and Pacific peoples are higher than for other ethnic groups
- all babies under the age of one, and Māori and Pacific children under 5 years old have the highest risk
- teenagers and young adults living in halls of residence and flatting are also at increased risk of the disease
- cases of meningococcal B disease have been decreasing since 2001 but it is important to remember that the disease has not entirely disappeared
What are the signs and symptoms?
Symptoms may appear in any order and some may not appear at all.
Get help immediately if you see one or more of the symptoms below.
A baby or child who has meningococcal disease may:
- have a fever (may also have cool hands and feet, or shivering)
- be crying or unsettled
- refuse drinks or feeds
- be sleepy or floppy or harder to wake
- dislike bright lights
- have a stiff neck
- have red or purple spots or bruises on the skin (see the above photo but be aware only 1 in 3 children with meningococcal disease have a rash)
An older child or adult may:
- have a fever or a headache
- have a stiff neck
- have joint pain and aching muscles
- be sleepy, confused, delirious or unconscious
- dislike bright lights
- have red or purple spots or bruises on the skin (see the photo above but be aware only 1 in 3 children/adults with meningococcal disease have a rash)
In the early stages of meningococcal disease, symptoms may seem similar to those of the flu or any other viral infection. The disease can develop very quickly and is difficult to diagnose.
It's important to be aware of the symptoms so you can get medical help straight away – whether it's day or night.
Meningococcal disease can be treated with antibiotics – but early treatment is very important.
Know about the early symptoms of meningococcal disease and take action if you are concerned.
When should I seek help?
Don't wait - take action
If your child has one or more of the symptoms of meningococcal disease:
ring a doctor, after hours medical centre or Healthline (0800 611 116) right away – whether it is night or day
- if it is an emergency, call 111 within New Zealand and ask for an ambulance (use the appropriate emergency number in other countries)
- say what the symptoms are
- insist on immediate action - don't be put off – a life may be at risk
- watch your child, even if they have already been cheecked by a doctor. Ask your doctor what to look out for
- go straight back to a doctor if your child gets worse
- do not leave your child alone
What treatments are available?
Meningococcal disease can be treated with antibiotics. Early treatment of meningococcal disease with antibiotics is very important because it can save lives and reduce the effects of the disease.
Can meningococcal disease be prevented?
The spread of meningococcal disease from person to person can be prevented once the disease has been identified and close contacts of that person are given antibiotics to clear the organism from their throat.
Several vaccines are available which protect against different groups of meningococcal disease - A, C, Y and W135. We currently have no licensed vaccine available in New Zealand effective against the B strain. Meningococcal vacines are not free (except for a few people with rare conditions) but they're available for private purchase through your family doctor (general practices) if people want them.
This vaccine is recommended and available free for certain people who have immune problems such as an absent or non functioning spleen or who have undergone a bone marrow transplant. Meningococcal immunisation is also funded for close contacts after a recent proven case of meningococcal disease, or to contain an outbreak.
Meningococcal vaccines are also recommended, but not funded, for:
- adolescents and young people living in or moving to communal living such as boarding houses, university hostels or military accommodation
- people with sickle cell anaemia or terminal complement deficiencies or HIV
- military recruits
- microbiologists and laboratory workers who could be exposed to meningococcal bacteria
- travellers to regions where this disease is common such as travellers to Hajj or people travelling to sub-Saharan Africa
For more information about meningococcal vaccines please talk with your doctor and look at the websites below.
Are there complications of meningococcal disease?
For every 100 people who get the disease, 4 will die. Another 20 are likely to be left with some degree of serious disability, such as brain damage, deafness, loss of limbs or damaged skin. A further proportion are left with learning or behavioural difficulties.
While New Zealand has had a high rate of meningococcal disease, it has had a low death rate compared to other countries. This is partly due to high awareness of the disease and the importance of seeking urgent medical attention, and to early treatment.
Between 2006 and 2010, there were between 5 and 8 deaths per year from meningococcal disease in New Zealand, and in 2013 there were 4 deaths.
This content has been produced by the Paediatric Society of New Zealand in collaboration with the Immunisation Team, Ministry of Health.
Thank you to Nelson Marlborough District Health Board for supplying the photo of the meningococcal rash.