Here are the basics of what you need to know about meningococcal disease and how to answer common questions about vaccination, writes charity Meningitis Now

Meningitis is the inflammation of the meninges, the membranes that surround the brain and the spinal cord. These membranes help protect the brain from injury and infection.

Meningitis occurs when bacteria or viruses invade the bloodstream and infect the meninges. The bacteria or viruses multiply rapidly and cause the meninges to inflame and swell. The brain is subjected to an increase in pressure that can cause symptoms such as a headache and a stiff neck.

In the most severe cases, this can cause injury to the brain. Infection can also spread to the inner ear, damaging the hair cells in the cochlea or causing inflammation of the auditory nerve, resulting in sensorineural
(or nerve) deafness.

Some bacteria that cause meningitis can also cause septicaemia. Septicaemia is caused by bacteria multiplying in the bloodstream. The bacteria release toxins that damage the walls of the blood vessels, causing them to leak. The immune system is unable to counteract these toxins.

As the vessels leak, the body reacts by reducing blood supply to the hands, the feet and the surface of the skin. The heart and lungs have to work harder to supply oxygen and nutrients to the vital organs. This can lead to multi-organ failure.

The toxins released by the bacteria also affect the clotting mechanism, which in turn affects the blood supply to the vital organs, causing tissue damage. The rash associated with septicaemia is caused by blood leaking into tissues under the skin.

Meningococcal disease (meningitis and/or septicaemia) 

• The number of cases per year in the UK ranges from 750 to 2,800.

• Around 7% of cases will result in death.

• Approximately 30% of survivors will be left with after-effects, many of which will be long-term, severe and disabling. The meningococcus (Neisseria meningitidis) bacteria can cause two major illnesses – meningitis and septicaemia – that together are known as meningococcal disease. These illnesses can occur on their own but commonly occur together.

There are 12 identified groups of meningococcal bacteria (meningococci) and, of these, five commonly cause disease — they are groups A, B, C, W and Y.

Meningococci are spread through coughing, sneezing and intimate kissing — approximately 10% of the general population carry meningococcal bacteria harmlessly in the back of their throats at any one time. This natural carriage is, therefore, relatively common and helps develop immunity.

Only a minority of carried meningococci are harmful. Infection is caused when the bacteria, for reasons that are not currently understood, move from the back of the throat into the bloodstream and multiply rapidly. Once in the bloodstream, these bacteria can cause septicaemia and, in many cases, infect the meninges and cause meningitis.

When a case of meningococcal disease occurs, public health action will identify close contacts and offer them antibiotics. This reduces the risk of further cases occurring. It is still vital for these contacts to be aware of the signs and symptoms of meningitis and the action to take if symptoms appear.

Vaccination

Vaccination can prevent certain types of meningitis. In the UK, vaccinations have been very successful and have saved thousands of lives. In addition to protecting the people who receive them, they help protect the wider community.

Most meningitis vaccines reduce the carriage of harmful organisms. As the number of people who are vaccinated increases, the risk of the bacteria spreading to those who aren’t is reduced. This is known as herd protection.

However, there are still types of meningitis that can’t be prevented by current vaccines and no single vaccine alone can prevent all types of meningitis.

The NHS UK vaccination programme

Babies and toddlers: 

• The Meningitis B vaccine is given at two, four and 12 months old. This protects against meningococcal group B disease.

• The Meningitis C vaccine is given at 12 to 13 months old. This protects against meningococcal group C disease. A dose given at three months was removed from the programme 1 July 2016.

• The pneumococcal conjugate vaccine is given at two, four and 12 to 13 months old. This protects against 13 different strains of pneumococcal bacteria.

• The Meningitis ACWY vaccine is given at around 14 years old. This protects against meningococcal groups A, C, W, and Y.  A limited catch-up for older teenagers due to be completed this year.

• The Men ACWY vaccine is available for first-year university students aged under 25, if they did not receive the vaccine while at school.

Adults 

The pneumococcal polysaccharide vaccine (PPV) is routinely offered to those over the age of 65. This protects against 23 strains of pneumococcal bacteria that cause pneumococcal disease.

All ages 

• The PPV is routinely offered to those who are at increased risk of developing pneumococcal disease due to long-term conditions (for example, those with no spleen or those who have kidney disease, heart disease or diabetes). It is not effective in the under-twos.

• The Meningitis B vaccine is offered to certain high-risk groups — for example, those with complement deficiency or who don’t have a spleen (asplenia) or who have splenic dysfunction.

Talking to the public about vaccinations

In the UK, the uptake of vaccines that prevent meningitis is generally good, particularly for childhood vaccines. However, parents often have questions about vaccines.

Are vaccines safe?

Vaccines are safe. Before being licensed in the UK, vaccines are thoroughly tested for safety and effectiveness and are constantly monitored to ensure safety.

Should I get my child vaccinated?

Vaccination is a parental choice but vaccines reduce the risk of getting this life-threatening disease. The UK childhood vaccination programme has been carefully developed to protect children when they are at the highest risk from preventable childhood diseases. The benefits of each vaccine have been assessed carefully and weighed up against any potential risks. Vaccination of children also protects the population as a whole.

If I get my child vaccinated will they be safe from meningitis?

Vaccines are not available for all types of meningitis and it is important to remain aware of the signs and symptoms. However, the chances of your child getting meningitis are reduced if they have had the relevant vaccines.

Do vaccines have side effects? 

Some babies and young children may experience swelling or redness around the site of the injection. Normally this resolves itself within two to three days and doesn’t require treatment.

Occasionally, babies and young children may develop fever following vaccination. The Meningitis B vaccination is particularly likely to cause fever.

All information supplied by Meningitis Now, the UK’s largest meningitis charity