Meningococcal disease is caused by Neisseria meningitidis or meningococcus. There are several different strains (serogroups). Globally, serogroups A, B, C, W 135 and Y most commonly cause disease.7 Most infections do not cause clinical disease.37a Many infected people become asymptomatic carriers of the bacteria and serve as a reservoir and source of infection for others.37a In general, susceptibility to meningococcal disease decreases with age, although there is a small increase in risk in adolescents and young adults.37a The most common symptoms of meningococcal disease are stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting.36 The disease is fatal in 5–10% of cases even with prompt antibiotic treatment in good health care facilities; among individuals who survive, up to 20% have permanent neurological complications.37a A less common but more severe (often fatal) form of meningococcal disease, in which there is rapid distribution of the bacteria in the bloodstream, is characterized by a bleeding skin rash and rapid circulatory collapse.36
Transmission36,37a The bacteria are transmitted from person-to-person, mainly by infected airborne droplets from coughs and sneezes of infected persons. Close and prolonged contact, such as kissing, sneezing and coughing on someone, living in close quarters or dormitories and sharing eating or drinking utensils, facilitates the spread of the disease. N. meningitidis only infects humans.
Geographical distribution37a Sporadic cases are found worldwide. In temperate zones, most cases occur in the winter months. Localised outbreaks occur in enclosed crowded spaces (e.g. dormitories, military barracks). In sub-Saharan Africa , in a zone stretching across the continent from Senegal to Ethiopia (the African “meningitis belt”), large outbreaks and epidemics take place during the dry season (November–June).
Risk for travellers37a Generally low. However, the risk is considerable if travellers are in crowded conditions or take part in large population movements such as pilgrimages in the Sahel "meningitis belt". Localized outbreaks occasionally occur among travellers (usually young adults) in camps or dormitories.
Vaccinations are available for N. meningitis for types A, C, Y and W 135 and is recommended for those who intend on travelling to parts of the world where epidemics of meningococcal disease occur. This includes the ’meningitis belt’ of sub-Saharan Africa.
- Saudi Arabia requires pilgrims to the Hajj to have proof of vaccination.
- Young adult travellers who intend on staying more than a month in either Europe or North America should be vaccinated.
- Avoid overcrowding in confined spaces. Following close contact with a person suffering from meningococcal disease, medical advice should be sought regarding chemoprophylaxis.37a
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