Acting quickly can save a life
Last week, the Ministry of Health sent out a warning about meningococcal disease. This very serious infection is sadly on the rise, with numbers more than doubling since 2014. This year has seen 96 cases to date, with several deaths.
The ministry’s information was partly aimed at health providers, ensuring all GPS and emergency departments have the most current treatment guidelines for cases of suspected meningococcal, but was also aimed at the public, to remind them of the symptoms and signs to look out for.
Although it’s not always possible to treat meningococcal successfully, the best chance of full recovery is to catch it as early as possible.
Meningococcal disease is caused by a group of bacteria known as Neisseria Meningitidis. There are at least 12 different strains of this bacteria around the world, including A, B, C, W and Y. In New Zealand, about two-thirds of our cases are caused by meningitis B, followed by groups C, Y and W.
Anyone can catch meningococcal infection, and in fact about 15 per cent of us will already carry this bacteria in our noses or throats without becoming unwell. The bacteria is spread in saliva droplets, so coughing, sneezing, sharing cups and kissing can all be risks.
We don’t fully understand why it causes such a terrible infection in some people, while others can be exposed to it without any ill effects at all. However we do know that some groups are at particularly high risk and should think seriously about protecting themselves with extra vaccines. These groups include:
Infants and children under 5 Ma¯ ori and Pasifika people, especially babies Teenagers and young adults, especially those living in close proximity to others, such as university accommodation or boarding school Smokers
People with a lowered immune system – this can result from certain types of immune deficiencies, or from taking medication such as long-term steroids or immunosuppressants.
Meningococcal infection can cause three types of illness: meningitis (an infection of the lining around the brain), meningococcal septicaemia (an infection of the blood), and pneumonia (infection of the lungs). All are extremely serious and carry a high mortality rate of around 10 per cent.
In the very early stages, meningococcal infection can mimic a simple flu, with fever, malaise, headache and runny nose. However, if any of the following are present, it is crucial to get checked immediately as it is possible that meningococcal is the cause. In this situation, even delaying by a few minutes can make all the difference:
Rapid progression of symptoms – people can deteriorate within hours or even minutes at times, as opposed to typical cold and flu viruses where the course tends to be more gradual Very high fever Muscle aches and pains Persistent headaches Stiffness or pain in the neck Dislike of bright lights Floppiness and lethargy – this can be especially prominent in babies who may be too tired to feed Vomiting Confusion A rash – if septicaemia is developing, a typical rash will appear. This purply-red rash won’t ‘‘blanch’’ (that is, go white) when pressed.
Even for health professionals, it can be super hard to tell if these symptoms are anything to worry about, or simply represent a bad dose of the flu, but if you are in any doubt I would suggest you go straight to your nearest emergency health provider for reassurance, especially if you are in one of the high-risk groups. Early treatment
with high-dose intravenous antibiotics can be effective, though sadly not in all cases.
As is so often the case, prevention is definitely better than cure. We have had vaccines available for strains A,C, Y and W for a long time (Menactra and Nimenrix), but much more recently a vaccine has also been developed against the meningococcal B strain (Bexsero).
A few groups are eligible to get these vaccines free in New Zealand (example, if you are on