Exposing a silent threat to students
As meningococcal cases rise, young people are urged to take action against the deadly disease, says Eleanor Doughty
‘I tried to warm up, but nothing helped; it was terrifying’
Like thousands of other new students, Sophie Royce is looking forward to the constant partying that is generally part and parcel of Freshers’ Week. But the 23-year-old, who is starting a nursing degree at London South Bank University, is keen to spread a more serious message. She is urging anyone heading for higher education to take up the offer of a new NHS vaccine against the deadly meningococcal disease.
Royce has good reason to speak out on the issue. Almost two years ago, she had her fingertips and toes amputated after contracting septicaemia (blood poisoning). The infection was caused by a particularly aggressive form of meningococcal disease called Meningococcal group W (or Men W).
The first symptoms she had, in July 2013, included headache and nausea, which doctors put down to a stomach bug. It was only when she woke up in the early hours shaking with cold that her partner, Matt, took fright and called an ambulance. “I tried to warm up, but nothing helped. I couldn’t regulate my body temperature; it was terrifying,” she says.
By the time Royce got to hospital, another more telling symptom had appeared: a purple rash, which began on her leg but rapidly spread all over her body. Meningococcal disease can cause both meningitis – an infection of the covering (meninges) surrounding the brain and spinal cord – and septicaemia, both of which are life threatening, although septicaemia is more likely to be fatal. Six different strains of bacteria – called A,B, C, W, X and Y – are mainly responsible for the disease. For decades, meningococcal B was the most common form in young children, although a new vaccine against this type is included in the childhood immunisation programme from this month. Meningococcal C was also common until the introduction of the Men C vaccine in 1999, which has reduced cases to just a handful a year.
But health officials have been worrying about Men W for some time. Although infection with this type is rare, cases have been rising steeply for some years due to a particularly virulent strain of the Men W bacteria. In 2009, there were 23 cases of Men W in England. By 2014, this had risen to 119 – a spike of 400 per cent. Cases of Men W are also associated with a higher than usual death rate, with 24 confirmed deaths reported during 2013 and 2014. The increase in cases has been particularly pronounced among young people and university students, according to the charity Meningitis Now.
Royce, who was working as a childminder in Reigate, Surrey, at the time, suffered total organ failure after contracting the disease. “My lungs were filled with fluid and I found it hard to breathe,” she says. She was on dialysis in intensive care at London’s St Thomas’ Hospital for three weeks before moving to nearby Guy’s Hospital for another month of renal treatment. “The doctors thought at the time the damage to my kidneys was irreversible as they had no function at all,” she says.
When her kidneys started to work again, Royce returned to her parents’ home in Surrey, with blackened tissue on her fingers and toes. Two days before her 22nd birthday in November, she had her fingertips and toes amputated, followed by skin grafts to lengthen her right foot, which had been damaged by the infection.
“I’ve had loads of problems but I’ve learnt to walk quite normally again now,” she says.
To tackle the disease, a new vaccination, Men ACWY, covering the A,C, W and Y strains of the illness, is being offered to 17 and 18-year-olds, as well as university students aged between 18 and 25. From spring 2016, the new vaccine will also replace the current Men C booster given to 14-year-olds.
While Men W cases have increased across all age groups, young people appear to be particularly vulnerable, with some 25 per cent of teenagers carrying the meningococcal bacteria in the back of the throat, says Dr Radha Modgil, medical presenter of The Sex Education Show on Channel 4. While, for most, natural resistance means the bacteria are harmless, infection occurs when the bacteria break through the protective lining of the nose and throat and enter the bloodstream.
Dr Modgil says that while most of us know about the risk of meningococcal infection in babies, the risk to young people is less known. The virus is transmitted by prolonged contact with an infected person, through saliva – “through things like sneezing, coughing, kissing, sharing toothbrushes”, says Dr Modgil. “It’s not as easily spread as a cold but it works in a similar way.”
Royce didn’t know much about meningococcal disease. “I thought it only affected babies and young children,” she says, “and the only symptoms I knew of were a headache and a rash.” Other symptoms include the fever and vomiting that Royce suffered, severe muscle pain, confusion and a stiff neck. “For me, the rash was the last thing to appear, and by that time it was quite late on,” she adds.
Health officials are keen to stress the importance of receiving the jab, available as a single dose in GP surgeries, especially for students starting university this year. “It is critical that young people are not complacent about the disease and take the necessary steps to protect themselves,” says Sue Davie, the chief executive of Meningitis Now.
Dr Modgil advises any young people who are not eligible for the vaccine – such as second and third-year students – to be mindful of symptoms that may feel like a hangover or flu, such as muscle aches, fatigue, headache and nausea.
As for Royce, the disease has dictated the course of her life in more ways than one. “I wasn’t sure what I wanted to do before,” she says. “But spending time in hospital has given me a goal in life. So something good has come out of it.”