What is meningococcal disease or meningitis?
Meningococcal disease is caused by the bacteria Neisseria meningitidis. Five types of the Neisseria bacteria (A, B, C, Y and W-135) cause almost all infections. The bacteria are found in the throat and nose in 10 percent of healthy individuals. In rare instances, the bacteria can overcome the body's natural defenses and cause serious disease. The two serious forms of the disease are an infection of the lining of the brain called “meningococcal meningitis” and a blood infection called “meningococcemia”.
Meningococcal meningitis is quite rare, with approximately 300 to 400 people affected in Canada (16 in Toronto) every year. The disease can affect people of any age, although it is most common in teenagers, young adults and infants less than 1 year of age.
How can someone get meningococcal disease?
The disease spreads through saliva by close face-to-face contact, usually by kissing or sharing food, drink, musical instruments, water bottles, cigarettes or other things that have been in the mouth of a person with the disease. It is not spread by being in the same classroom or on the same bus with an infected person.
What are the symptoms of the disease?
Symptoms can come on very fast and make someone very sick. Early symptoms of meningococcal disease include sudden onset of fever, a severe headache, nausea, vomiting, and fatigue followed by a stiff neck, sensitivity to light, dizziness and a red/purple blotchy rash. Infants can have a high pitched cry, an arched back, decreased appetite or difficulty feeding.
How soon do symptoms appear after infection?
Symptoms usually appear 2 to 10 days after being exposed to the bacteria.
Can the disease be treated?
Treatment is with antibiotics and supportive medical care. However even with the right treatment, the disease can be very serious and can lead to severe complications or death.
Who is at increased risk of getting meningococcal disease?
Children under the age of 5 and particularly those under the age of one are at highest risk, followed by adolescents and young adults. Close contacts of individuals with meningococcal disease and individuals without a spleen or who are immunocompromised are also at increased risk.
Can meningococcal disease be prevented?
Yes. Vaccines are available that provide protection against some types of meningococcal disease. Meningitis C vaccine (Meningitec™, Menjugate™, NeisVac-C™) protects against type C meningococcal disease and is available free of charge in Ontario to one year olds, grade 7 students and adolescents between 15 and 19 years of age. Another vaccine, Menactra™, is now available and protects against types A, C, Y and W-135.
What are other ways to prevent meningococcal disease?
Avoid sharing cups, water bottles, cigarettes, food and other utensils. Always clean musical instrument mouth pieces after each use.
Who should get Menactra™?
Menactra™ is not necessary for everyone. You should get Menactra™ if you are between 2 to 55 years of age and in the following high-risk groups:
- individuals without a spleen
- anyone with a complement, properdin or factor D deficiency
- employees who work in a lab and are exposed to N. meningitidis
- military recruits
- anyone who is a close contact of a person with meningococcal disease caused by types A, Y or W-135
- people who travel to a destination where the vaccine is recommended (including going on a pilgrimage to the Hajj in Mecca) should get the vaccine at least 2 weeks before leaving.
Menactra™ can sometimes be recommended for those between 11 to 24 years of age based on the activity of types A, Y or W-135 meningococcal disease in the community.
Is Menactra™ currently available free of charge?
Menactra™ is only publicly funded in Ontario for persons between the ages of 2 and 55 who do not have a spleen or are a close contact of a confirmed case of meningococcal disease caused by types A, Y or W-135.
What are the possible side effects of getting Menactra™?
Menactra™ is a safe vaccine. Common side effects include pain, redness and swelling where the vaccine was given. They generally last about 3 days. Other common side effects include headache, fatigue, irritability and drowsiness. Severe local and systemic reactions are uncommon.
Shortly after receiving Menactra™, a small number of individuals, mostly adolescents and young adults between 11 and 19 years of age, were diagnosed with Guillain-Barré Syndrome, a neurological disease that can lead to paralysis. No link has been established between this neurological condition and the vaccine.
Rarely, individuals have been diagnosed with transverse myelitis, a swelling of the spinal cord that can lead to numbness, weakness and other symptoms which can be permanent. No link has been found between this neurological condition and the vaccine either.
In children between 2 and 4 years of age seizures were rarely seen but it was not possible to determine if the seizures were connected to the vaccine.
Who should not get Menactra™?
Those who have had a negative reaction to any vaccine should see their doctor before being immunized. Individuals with a history of Guillain-Barré Syndrome should not get this vaccine. Women who may be pregnant or who are breastfeeding should talk to their doctor before receiving this vaccine. People who have received Menomune TM, another vaccine against meningococcal disease, should wait at least 6 months before getting this vaccine.
Where can I get Menactra™?
A doctor or other health care provider can give this vaccine to eligible individuals. Remember to tell the doctor or your health care professional about any side effects you have had to vaccines or other medicine. Be sure to update your yellow immunization card every time a vaccine is given. For children in Toronto schools, parents should send information on vaccines given to their children to Toronto Public Health’s Immunization Information Line.
Where can I find more information?
For further information, ask your doctor or call Toronto Public Health Immunization Information Line at 416-392-1250.
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