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        Meningococcal disease

        Meningococcal disease

        Meningococcal disease is caused by the bacteria Neisseria meningitidis, or 'meningococcus'. It is an uncommon but very serious disease that can result in death if not recognised and treated quickly.

        Meningococcal disease can present as meningitis (infection in the fluid surrounding the brain), septicaemia (blood poisoning which can damage the organs of the body), or a combination of both.

        While most people will recover from meningococcal disease, around 10% of cases are fatal, and between 10-30% of surviving children and adolescents are left with brain injury and/or deafness, severe scarring or amputated limbs.

        Babies and young children less than 5 years old, teenagers and young adults have the highest risk of contracting meningococcal disease.

        Meningococcal variants

        There are 13 known variants, or serotypes, of meningococcus,although only 5 of these are known to cause disease - A, B, C, W and Y. The proportion of serotypes found in the community can vary depending on the season and location. MenC was previously the most common serotype seen in Australia. Now MenB  and MenW are the most common. MenA and MenY serotypes are rare in Australia.

        The important feature of meningococcal serotypes is that they are just different enough to trick our immune system into thinking they are not the same bacteria. This means that if you have immunity to one serotype (e.g. MenC), you won't be protected against the other serotypes. It also means that each serotype requires its own vaccine.

        The proportion of circulating meningococcal serotypes is different in WA than in the rest of Australia. The most recent data showed that 75% of meningococcal disease is caused by MenW, followed by MenB and MenY.

        Meningococcal vaccines

        Vaccination against meningococcus is the most effective way to prevent disease.

        There is no single vaccine that protects against all serotypes of meningococcus, but there are vaccines available against all the disease-causing meningococcal serotypes.

        All babies are now offered a free Meningococcal ACWY vaccination when they turn 12 months old. This replaces the infant MenC vaccine program introduced in 2003, which resulted in a marked decline in this strain of the disease but did not cover multiple strains. The WA Government is also providing the ACWY vaccine to children and teenagers in certain age brackets, and more information about this is listed in the ACWY vaccine program information below.

        All the meningococcal vaccines currently available have been evaluated by the Therapeutic Goods Administration (TGA), and are safe to use in the recommended age groups.

        The ACWY vaccine program

        In response to the concerns about the recent increase in MenW meningococcal disease, the WA Government has announced that all Western Australian children aged one to four years will have access to a free meningococcal ACWY vaccine in 2018. The vaccine provides protection against the A, C, W and Y serotype, and parents should contact their local GP or Child Health Clinic to schedule an appointment for their child. 

        The WA, NSW and Victorian governments also provided the ACWY vaccine free to teens and young adults aged 15-19 thoughout 2017 and will continue to vaccinate students entering Year 10. This age group is targeted because many cases of meningococcal disease occur in older teens and young adults, and by vaccinating the group who are more likely to carry the bacteria, it is expected that the majority of MenW type bacteria circulating in the community will be eliminated, reducing the risk of infection for everyone.

        For more information about the ACWY vaccinations being provided, please see the WA Department of Health website.

         

        Meningococcal Disease

        Signs and Symptoms

        Signs and Symptoms of Meningococcal Disease

        Meningococcal disease is an uncommon but very serious disease that can result in death if not recognised and treated quickly. Vaccination against meningococcus is the most effective way to prevent disease. Dr Peter Richmond, Head of the Vaccine Trials Group at Telethon Kids, explains the symptoms to look out for, which age groups are most at risk, and the different strains of the disease and the associated vaccinations to help protect kids from the disease.

        Quick Facts

        Meningococcal disease is an uncommon but potentially fatal disease caused by infection with Neisseria meningitidis, or meningococcus.

        Symptoms in babies include:

        • fever
        • rapid breathing or panting
        • vomiting or difficulty feeding
        • irritability
        • lethargy or difficult to wake
        • unusual crying or moaning
        • rash

        Symptoms in older children and adults include:

        • fever
        • headache
        • vomiting and diarrhoea
        • neck stiffness
        • muscle or joint pains
        • drowsiness or confusion

        These symptoms may be accompanied by the appearance of a spotty red-purple rash that looks like small bleeding points beneath the skin. It is important to get this type of rash checked by your doctor promptly.

        Children under 5 years, teenagers and young adults are most at risk of contracting meningococcal disease.

        Vaccination against meningococcus is the only effective way of protecting your children against meningococcal disease.

        Meningococcal vaccines

         

        MenB vaccine

        Quadrivalent (ACWY)
        meningococcal vaccines

        Description

        The MenB vaccine (Bexsero; Novartis Vaccines and Diagnostics Pty. Ltd.) is recommended for babies and young children less than 2 years of age, and for adolescents and young adults. Although MenB vaccine is safe and protective against MenB type disease, it is not provided for free. The Pharmaceutical Benefits Advisory Committee (PBAC) determined that the large cost of routine MenB vaccination was not justified due to the rarity of MenB disease.

        The ACWY vaccine provides protection against four meningococcal serotypes - MenA, MenC, MenW and MenY. The ACWY vaccine has been shown to be safe, and is able to stimulate the production of antibodies against MenA, MenC, MenW and MenY in babies, children and adults at levels high enough to provide protection. A single dose of ACWY vaccine, which has been in use in the US for several years, is estimated to reduce the risk of infection with these types by 80-85%.

         

        Effectiveness

        Because meningococcal disease is now rare, it has not been possible to conclusively prove the effectiveness of MenB vaccine in clinical trials – such a trial would require millions of participants over many years. However, when this vaccine is given as part of a recommended dose schedule it has been shown to stimulate protective antibodies against MenB at levels high enough to prevent disease.

        		  

        Dose schedule

        The dose schedule depends on the age of the child when the first dose is given: if the vaccine is given to babies less than 3 months of age, 3 doses are required; for babies and children older than 6 months, only 2 doses are required. For more information on dose schedules, check with your GP or see the Immunise Australia Program website.

        For babies less than 6 months of age, 3 doses are required, followed by a booster dose at 12-18 months and then again 3 years later.

        For babies and children older than 6 months, 2 doses are required, with a booster dose 3 years after the first dose.

        Additional booster doses are needed every 5 years after the 3-year booster dose.

        For more information on dose schedules, check with your GP or see the Immunise Australia Program website.

        Safety

        The MenB vaccine often causes fever in the 24 hours after dosing, especially if given at the same time as other routine vaccines. While this fever is not dangerous, paracetamol (at an appropriate dose for age) is recommended with each vaccine dose. This is an exception to the recommendation that paracetamol should not be given routinely at the time of infant vaccinations.

        Other common side effects include tenderness, swelling and redness at the injection site, as well as irritability, sleepiness, unusual crying and change in appetite. The frequency of fever is two times higher if the MenB vaccine is given with other childhood vaccines.

        Common side effects are similar to those experienced with other vaccinations, such as pain, redness and swelling at the injection site, fever, irritability, drowsiness, decreased appetite and headaches. Rash and nausea are also sometimes reported after ACWY.

        Cost

        Approximately AU$125 to AU$135 per dose, not including the cost of the GP consultation.

        All babies are offered a free Men ACWY vaccine when they turn 12 months old as part of the National Immunisation Program.

        A free vaccination program is also being provided by the WA government for children aged 1-4 and teenagers aged 15-19. Speak to your GP for more information.

        The Men ACWY can be purchased privately for use in other age groups according to availability. The cost per dose of ACWY varies depending on the vaccine, but approximately AU$80 to AU$100 per dose. The cost does not include the GP consultation.