Meningococcal disease: Dr Sam on symptoms, treatment and vaccines available

Utter the words “meningococcal disease” and you’re sure to put the fear of God into any parent. Listen in at any mothers group in the café, or scroll through Facebook feeds and news outlets, and you’re sure to be left confused.

Just what do we need to know with all of the recent outbreaks on the rise? Dr Sam Hay discusses meningococcal disease and explains exactly what we need to know about the vaccines out there.

Firstly, let’s discuss the facts about the disease itself

Meningococcal disease is caused by the bacteria Nisseria meningitidis, commonly called ‘meningococcus’. There are 13 different strains, with the most common being A, B, C, W135, and Y.

When meningococcal disease is severe it manifests as:

• Meningitis
• Septicaemia (or ‘sepsis’ - an overwhelming blood infection which leads to the characteristic rash, and makes you bloody sick)
• Or both

It mainly affects our kids, with peaks in the under fives, and teenagers (15-19 year olds).

Classically outbreaks occur in winter and early spring. It’s transmitted by sneezing, coughing, kissing, and sharing food and drinks.

Why is everyone worried about it?

Meningococcal disease garners such attention because it can be a catastrophic disease.

Whilst most people survive unscathed, it’s fatal in about five percent of cases. A staggering 30 percent are left with some sort of permanent disability, including limb deformity, skin scarring, deafness, and other neurological issues.

Whilst Meningococcal disease is scary, we must remember it’s a rare condition - we only see about three cases per 100,000 Aussies each year.

What’s the current picture in Australia?

Meningococcal disease is rare, and thank goodness the rate of cases is dropping.

Jump back prior to 2003, and strain B accounted for about 50 percent of cases, C about 30 percent, and the other strains made up the difference. The introduction of the national immunisation program for strain C in 2003 has almost completely wiped the C strain out. There’s been a whopping 99 percent reduction in reported cases – a simply amazing feat and only proves the effectiveness of immunisations to all the naysayers.

The success of the C vaccine, given to all kids at their 12 month shots, has also dropped the overall prevalence of meningococcal disease by 82 percent! Rates have plummeted from 3.5/100,000 in 2002 to 0.6/100,000 in 2013.

However, since 2014 the number of cases have been on the rise again. Part of the problem is that notifications of W strain infections doubled from 2014 to 2015, then tripled in 2016.

W strain is a more deadly form of the disease, with a higher than usual death rate of 10 percent. Plus, W strain infections are usually only experienced by adults – but unfortunately since 2015, it’s the kids who have been suffering – something has changed, it’s a more virulent strain.

W strain is a more deadly form of the disease, with a higher than usual death rate of 10 percent. Image: iStock 

So what’s being done?

Health Departments across Australia have responded to this crisis by introducing W strain vaccination programs in the last six months.

Teenagers are most likely to harbour the infection and are critical for transmission – so that’s why they are the priority for vaccination at the moment. By protecting them, health authorities hope to halt the W strain crisis in its tracks, and therefore protect our kids.

What about the kids? Should I get my little ones vaccinated?

Strain C

There’s not much of a decision to be made because the vaccine is part of the standard immunisation schedule for all 12 month olds in Australia. The track record speaks for itself.

Strain B

A vaccine was released in 2013 – 4CMenB/Bexsero – with much fanfare. It’s available, but the decision to vaccinate is a little trickier. At the crux of the dilemma for many is the fact you have to pay for it, because it’s not currently on the government funded immunisation schedule.

• It costs approximately $130 per dose, with up to three doses per child required.
• It most situations it can be given with other vaccines, including the standard immunisation schedule, however you’ll need to discuss this with your doctor first.
• Whilst safe, there isn’t any evidence to say how effective the vaccine is yet.
• There is a high rate of fevers in over 50 percent of babies after the shot. You MUST give your child a dose of paracetamol prior to vaccination.
• In general, it is recommended for all healthy babies under the age of two years, especially those with other medical conditions.
• It is also recommended for adolescents aged 15 to 19.

Strain W

There’s clearly a very strong argument to vaccinate our little ones, as well as the teenagers already getting jabbed. Your GP can organise a specific vaccine for you and it costs about $120. But…. There’s just not many actual vaccines about in Australia at the moment, so it’s practically going to be very difficult. Unfortunately the vaccines are only approved for kids over the age of two.

Despite the cost and some side effects, Dr Sam urges all parents to vaccinate themselves and their families. Image: iStock. 

So where does that leave us then?

The choice to vaccinate your kids against the B and W strains will remain a personal one for each parent.

Meningococcal disease, no matter which strain is the culprit, is a rare but devastating illness. There are vaccines available, but they come with costs and some side effects.

I urge you all to see your doctor and have a chat.

But I must admit if you ask me, it’s bloody hard to argue the case NOT to have all available meningococcal vaccines.

For more details, head to Meningococcal Australia