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Meningococcal Meningitis

What is meningococcal meningitis (spinal meningitis, cerebrospinal fever, meningococcemia)?

Meningococcal meningitis is a severe bacterial infection of the meninges (a thin lining covering the brain and spinal cord) caused by the bacteria called Neisseria meningitidis. Meningococcemia is the term for infections involving the bloodstream. The infection can also occur as pneumonia (an infection of the lungs) or in joints, such as the knees. In 2003, there were 43 cases of invasive meningococcal disease reported among New York City residents (rate of 0.5 cases per 100,000 persons).

Who gets meningococcal meningitis?

Anyone can get meningococcal meningitis. Infants < 12 months of age have the highest rates of disease. Clusters of cases and outbreaks do occur but are rare in the United States.

How is meningococcal meningitis spread?

The meningococcus bacteria is spread by direct close contact with nose or throat discharges of an infected person. About eight percent of healthy people carry this particular bacteria in their nose and throat without any signs of illness. Why certain people become ill upon acquiring the organism is not fully understood. Close living quarters, such as in military barracks and dormitories, favor transmission of the organism.

What are the symptoms of meningococcal meningitis?

Although most people exposed to the meningococcus bacteria do not become seriously ill, some may develop fever, headache, vomiting, stiff neck and a rash. Sometimes the disease can be fatal.

How soon after infection do symptoms appear?

The symptoms may occur 2 to 10 days after exposure, but usually within 5 days.

When and for how long is an infected person able to spread the disease?

An infected person may be contagious from the time he or she is first infected until the germ is no longer present in discharges from the nose and throat.

How is meningococcal meningitis diagnosed?

Meningococcal meningitis is usually diagnosed in an ill person by laboratory identification of the bacteria from either the blood or spinal fluid.

What is the treatment for meningococcal meningitis?

Several antibiotics are very effective in eliminating the bacteria from the nose and throat. Penicillin is still effective against the meningococcal organism and remains the recommended treatment.

Should people who have been in contact with a diagnosed case of meningococcal meningitis receive preventive treatment?

Only people who have been in prolonged close contact (household members, intimate contacts, health care personnel performing mouth-to-mouth resuscitation, day care center playmates, etc.) need to be considered for preventive treatment. Such people are usually advised to obtain a prescription for an antibiotic (either rifampin or ciprofloxacin) from their physician. Casual contact, as might occur in a regular classroom, office, factory or other work setting is not usually sufficient enough to cause concern.

Is there a vaccine to prevent meningococcal meningitis?

Presently, there are 2 vaccines that will protect against four of the strains of the meningococcal organism (referred to A, C, W, and Y); one common strain, referred to as B, is not included in either vaccine.

One vaccine is the meningococcal polysaccharide vaccine, Menomune [TM](MPSV4), that is licensed for use in persons 2 years of age and older. The second vaccine, a meningococcal conjugate vaccine (Menactra [TM], MCV4), was licensed in January 2005 for use in persons 11-55 years of age.

The Advisory Committee on Immunization practices has issued preliminary recommendations for the routine use of MCV4 for:

  • Children at the pre-adolescent visit (11-12 years of age);
  • Adolescents at high school entry (15 years of age);
  • All college freshmen living in dormitories.

Other populations at increased risk for meningococcal disease for which routine vaccination is recommended have not changed are:

  • Persons with functional or anatomic asplenia;
  • Persons with terminal complement deficiency;
  • Laboratory personnel who are exposed routinely to aerosolized N. meningitidis;
  • Persons who travel to, or reside in, countries in which N. meningitidis is epidemic.

Use of MCV4 is preferred in person aged 11-55 years. Use of MPSV4 is recommended in persons at high risk for meningococcal disease who are 2-10 years of age or older than 55 years of age. MPSV4 may continue to be used for persons 11-55 years of age.

Is meningococcal vaccine required for school entry or for summer camp?

No. However, a recent change to New York State public health law now requires that colleges, universities, boarding schools, and children's overnight camps inform students or their parents or guardians about meningococcal meningitis (also called meningococcal disease). More information can be obtained from:

The law requires that the following information be provided:

  • A description of meningococcal disease and its transmission,
  • The benefits, risks and effectiveness of immunization, and
  • The availability and estimated cost of immunization (and whether or not the camp itself offers the vaccine).

The law does not require that a person receive meningococcal vaccination.

For more information on meningococcal meningitis, call 311