Meningococcal Meningitis

Background

Meningococcal Meningitis (Neisseria meningitides) is the leading cause of bacterial meningitis among U.S. toddlers, children, and adolescents. Meningococcal disease can cause meningitis (swelling of the brain or spinal cord) or meningococcemia (blood infection). Approximately 1,000 to 2,600 Americans get meningococcal disease annually, with disease rates peaking in adolescents aged 15-19 years. The disease can progress quickly, with poor health outcomes: adolescents are up to five times more likely to die than other age groups. Among survivors, 1 in 5 will suffer permanent complications, such as amputation, hearing loss, neurological damage, or organ failure.

Symptoms and Risk Factors

Early symptoms can resemble the flu, making diagnosis difficult. Symptoms include fever, headache, stiff neck, nausea and vomiting, and rash. The disease is spread through close, personal contact and exchange of respiratory secretions. Common everyday activities can put adolescents at increased risk for infection. These activities include:

  • Sharing drinking glasses and eating utensils;
  • Kissing;
  • Living in close quarters; and
  • Smoking (or being exposed to smoke).

Prevention

Meningococcal disease can occur at any point during the year, though late-winter and early-spring are when most cases occur. Once diagnosed with meningococcal disease, early antibiotic treatment is critical. Close contacts, such as family and friends, should receive preventive antibiotics to stop further spread of the disease.

School-based health centers can help protect children and adolescents against meningitis by providing outreach and education to parents and students, as well as by vaccinating patients. In California, nearly half of adolescents ages 13 through 17 have not been vaccinated against the disease, leaving many unprotected. SBHCs should consider pairing patients’ mandated Tdap booster with the meningococcal vaccine whenever possible. (See below for a recent update to the meningococcal booster recommendations for adolescents.)

Resources

Booster Vaccination

The American Academy of Pediatrics has endorsed the Advisory Committee on Immunization Practices (ACIP) recommendation for the use of meningococcal conjugate vaccine as a booster dose in 16-18 year olds. The ACIP concluded that a booster dose is the best immunization strategy to help protect adolescents during the entire period of increased risk and provide more opportunities to increase immunization rates.  For additional information about these new recommendations, please see the AAP policy statement; and Morbidity and Mortality Weekly Report.

Off to College Meningococcal Vaccine Campaign

This fact sheet, from the California Department of Public Health, is designed for students heading off to college. It explains the risks of meningococcal meningitis and recommends that all college-bound students get immunized.

Voices of Meningitis

The California School Nurses Organization has joined the National Association of School Nurses’ Voices of Meningitis campaign to raise awareness about meningococcal meningitis and encourage vaccination for pre-teens and teens in California. This is a public awareness campaign conducted in collaboration with Sanofi Pasteur.

To order Voices of Meningitis educational materials, including fact sheets, brochures and posters, please go to www.VoicesOfMeningitis.org or contact Deena Kimball. All materials will be shipped free of charge.