Questions & Answers
Meningococcal - The Disease
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  1. What causes meningococcal disease?
    Meningococcal disease is a severe acute infection caused by the bacterium Neisseria meningitidis (also known as meningococcus). Meningococcus infects the bloodstream and the lining of the brain and spinal cord (causing meningitis). Five different types of meningococcal bacteria cause virtually all meningococcal disease in the world. These types are grouped based on a complex sugar that coats the bacteria (called a polysaccharide). These five types of meningococcal bacteria are called serotypes A, B, C, Y, and W-135.

  2. How do you know if you have meningococcal disease?
    The most common symptoms are high fever, chills, tiredness, and a rash. If meningitis is present, the symptoms will also include severe headache and a stiff neck (which may not be present in infants); seizures may also occur. Symptoms can be mistaken for other illnesses and can unfortunately lead to delayed diagnosis and treatment.

    Diagnosis is made from blood and spinal-fluid samples. Any bacteria found are grown in a medical laboratory and identified.

  3. How serious is meningococcal disease, especially to the Armed Forces?
    Meningococcal bacteria are very dangerous, because they rapidly make large quantities of a poison called endotoxin. Endotoxin damages small blood vessels and causes low blood pressure and shock. For this reason, meningococcal bacteria can kill people soon after entering the bloodstream. Meningococcal disease can be so rapid and overwhelming that even appropriate, early medical care can be too late. About 10% to 15% of people with meningococcal disease die. Of those who survive, up to 20% suffer from permanent hearing loss, limb loss, or neurological damage. Amputations may be necessary because of reduced blood flow to fingers, toes, or limbs.

    Because meningitis can be caused by different types of meningococcus and other microbes, being immunized against Neisseria meningitidis or having had the disease will not protect against these other sources of infection. The other causes include bacteria such as Streptococcus or Haemophilus, viruses, or fungi.

  4. Is there a treatment for meningococcal disease?
    Meningococcal disease can be treated with antibiotics. It is critical to start treatment early. Even with treatment, about 10% to 15% of patients die.

  5. Can meningitis be caused by a virus?
    Yes. The word "meningitis" refers to inflammation of the tissues covering the brain and spinal cord. This inflammation can be caused by viruses and fungi, as well as bacteria. Viral meningitis is the most common type. It has no specific treatment, but it is usually not as serious as meningitis caused by bacteria.

Rate and Spread

  1. How common is meningococcal disease in the United States?
    The disease is most common in children less than one year old and in people with certain medical conditions. Others at risk include travelers to places where meningococcal disease is common, those with damaged or missing spleens, and people with certain blood diseases. Other factors include having a previous viral infection, living in a crowded household, having an underlying chronic illness, and being exposed to cigarette smoke - either directly or second-hand. College freshmen living in dormitories are at greater risk than others their age.

    Each year in the United States an estimated 2600 people are infected with meningococcus and 300 die from the disease. Meningococcal disease is more common in Africa and is the frequent cause of epidemic meningitis outbreaks. In Africa, such epidemics occur regularly within a well-limited geographic zone, the so-called African meningitis belt. In the countries within the meningitis belt, the illness is endemic and sporadic: numerous cases of meningococcal meningitis are reported each year during the dry season, and every 6 to 12 years a large outbreak occurs. The World Health Organization estimated meningococcal disease was the cause of 171,000 deaths worldwide in 2000.

  2. How does meningococcal disease spread from one person to another?
    The disease is spread person-to-person through the exchange of respiratory and throat secretions (e.g., coughing, kissing, sharing eating utensils). Meningococcal bacteria cannot live for more than a few minutes outside the body, so the disease is not spread as easily as the common cold or influenza.

  3. Can you get meningitis more than once?
    Yes, because meningitis results from infection by different types of the meningococcal bacterium, by other bacteria such as Streptococcus and Haemophilus, and by viruses and fungi.

  4. What can be done to protect those exposed to someone with the disease?
    Individuals who have been exposed to a person with bacterial meningitis can be protected by starting antibiotics immediately (within 24 hours of diagnosis). Antibiotics are usually recommended for household contacts and children attending the same daycare or nursery school as the person who is sick. Older children are not usually considered exposed, unless they have had intimate contact with an infected person, such as kissing or sharing a glass. Immunization may also be recommended for those two years of age and older.