Information on Meningococcal Meningitis

Introduction

Meningococcal infections are caused by different types ("serogroups") of N. meningitidis bacteria. In certain developing countries, large epidemics caused by serogroup A occur frequently, and serogroup A is the major cause of epidemics in areas of risk to travelers. In Canada and other industrialized countries most outbreaks are caused by serogroups B or C.

N. meningitidis bacteria enter the body through the upper respiratory tract. People can acquire the disease by inhaling the bacteria (when an infected person coughs on them, for example), by kissing an infected person, or by contact with objects that are recently contaminated with an infected person's nasal secretions.

Most people who become infected develop very mild upper-respiratory symptoms or no symptoms at all. More serious cases occur when the bacteria are able to enter the bloodstream (meningococcemia or sepsis) or the membranes of the spinal cord and brain (meningitis). Meningococcemia is characterized by rapidly developing symptoms of fever, chills, weakness, and rash. Symptoms of meningitis include severe headache, stiff neck, high fever, nausea and vomiting, and sensitivity to light. If the disease progresses, it can lead to convulsions, coma, and death. Because these types of meningococcal disease can progress rapidly and can be fatal, early detection and prompt treatment with antibiotics are extremely important.

Risk to travelers

Meningococcal infections occur worldwide but are most common in poor, overcrowded areas. The disease seems to have a seasonal increase in winter and spring. It can occur at any age and is most common in children younger than 5 years but older adults are also at increased risk.

Epidemics occur frequently in developing countries, especially in Africa and Asia, including the sub-Saharan "meningitis belt" of Africa (especially during the December-June dry season). Epidemics have occurred on an irregular basis in other countries (for example, Brazil and Chile).

In general, risk to travelers is low and cases are rare. However, risk increases as the length of stay increases and the level of contact with local populations increases. Staying in crowded facilities such as hostels and schools will increase the risk. College freshmen, particularly those who will live in dormitories or residence halls, are at modestly increased risk. Persons without a working spleen are especially at risk, as are persons with a certain deficiency in their blood's immune system.

Prevention

In addition to vaccination, travelers at risk should stay away from crowded areas frequented by local inhabitants, avoid other close physical contact, and wash their hands or use Isagel after touching hands or objects that could be contaminated with nasal secretions.

Vaccination

The vaccination against meningococcal disease is usually not a requirement for entry into any country except Saudi Arabia, which requires proof of vaccination for those making the pilgrimage to Mecca for Hajj or Umra. The vaccine should be given at least 10 days before arrival in Saudi Arabia and no more than 3 years prior to arrival.

Menactra:

MENACTRA® is indicated for active immunization for the prevention of invasive meningococcal disease caused by N. meningitidis serogroups A, C, Y and W-135 in persons 2 to 55 years of age.
MENACTRA® will not protect against disease caused by meningococcal strain B, and is not a treatment for meningococcal infections or their complications.

Menveo:

Menveo is a vaccine indicated for active immunization to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135. Menveo is approved for use in persons 2 to 55 years of age. Menveo does not prevent N. meningitidis serogroup B infections.

Mennomune:

This vaccine is an injectable, inactivated-bacteria vaccine. It protects against types A, C, Y and W-135 and is about 85-90% effective against these types. The vaccine does not protect against types B, D, L, X and Z.

Menjugate:

Is an injectable, conjugated vaccine. It is very effective against the C type only.

Who should consider vaccination?

Meningococcal Meningitis Vaccination is recommended or should be considered for:

Persons traveling to sub-Saharan Africa, especially during the dry season (December to June), and/or to other areas of current or recent epidemic activity
Persons who have had their spleen removed or have an impaired spleen
Persons with a blood disorder called component deficiency in the final complement pathway
College students with immune deficiencies or who are traveling to areas of current or recent epidemic activity
Research, industrial, and lab personnel who are routinely exposed to N. meningitidis bacteria
Travelers to Mecca at any time, especially if they will have prolonged or intimate contact with the local populace
Travelers to and expatriates residing in countries recognized as having epidemic meningococcal disease, especially if they will have prolonged or intimate contact with the local populace
College students, especially freshmen, who will be living in dormitories or residence halls

CAUTION

If you are pregnant, you should not receive this vaccine unless you are clearly at risk (visiting a known epidemic area, for example).
If you know that you are allergic to mercury or thimerosal (a preservative), be sure to tell your health care provider before receiving this vaccine.

Vaccination schedule

This vaccine is usually administered in a single dose.You must receive the vaccine about 2 weeks before departure, since it takes that much time to attain full protection.

Menactra and Mennomune need to be boosted after 3 to 5 years.

Menjugate is effective for at least 10 years and possibly longer.

Vaccine Prices

Click here to see our Meningitis vaccination prices.

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