Meningococcal disease: The facts

Meningococcal
Meningococcal disease featured heavily in our newsprint and other media types throughout 2017; a result of the potentially tragic impact that it can have on both children and adults alike. There are 13 known different types of meningococcal disease that can be transmitted in humans. The majority of cases however involve 5 main serogroups; these being A, B, C, W and Y.

Meningococcal Disease in 2017: What strains were diagnosed?
In 2017, WA experienced twice as many cases of Meningococcal disease as were seen in the previous year (2016). Out of the total 46 persons to be diagnosed throughout the year, 23 contracted serotype W, 12 cases were due to serotype B, 9 to serotype Y, 1 to serotype C. The remaining case was unable to be identified.

How is it transmitted and who is at greater risk of acquiring it?
Meningococcus is a bacterial infection caused by Neisseria meningitis. It is passed from person to person via respiratory droplets or direct contact with persons that have the infection. It is important to know that the infection can progress rapidly, even in previously healthy people. The risk of contracting the disease is higher in immune-compromised people (for example those without normal spleen function or HIV). Certain population groups are also at higher risk of contracting this infection. For example, laboratory workers that are exposed to the bacteria and university students (due to characteristic social interactions).

Symptoms
Clinical symptoms of meningococcal disease may include one, all of, or a combination of the following: high fever, head ache, neck stiffness, light sensitivity, a change in conscious level (drowsiness or confusion), rash or nausea and vomiting. Unlike many other rashes, the rash associated with this infection does not fade when compressed. However, not all people that contract Meningococcal disease will get this specific rash.

Those that contract this disease face a considerable mortality risk of between 5 to 10%.

Alternately, some people who contract this disease do not display any symptoms (asymptomatic). These people are typically known as carriers of the bacteria and may never experience the full impact of the disease.

How protection is provided (First Dose)
Meningococcal infection is a vaccine-preventable disease. The WA Childhood Immunisation Schedule recommends that a child receives their first meningococcal vaccine at 12 months of age (Menitorix). This is a free vaccine for those in this age group and targets the Meningococcal C strain. Menitorix is a combined vaccine (conjugate) which aims to prevent infectious diseases caused by Haemophilus Influenzae type B (Hib) and group C meningococcal.  Haemophilus Influenzae type B can cause meningitis.

Since the inception of this vaccination program to target Meningococcal C, the number of reportable cases of this strain has been considerably low. Unfortunately, there is currently no single vaccination that can prevent all 13 serotypes of the meningococcal disease.

New program launch: Paediatric Meningococcal ACWY Program
On the 23rd January, 2018 the WA State Government launched the Paediatric Meningococcal ACWY Program. At present, the program is targeting all children living in WA that are between 12 months to <5 years; funding has been provided until the 31st December 2018. If your child is between these age points, the vaccination to prevent the ACWY strains is free and can be accessed from your GP or Community Health Nurse now.

Only 1 vaccination is required to provide full protection; however there are different vaccine brands recommended dependent on the age of the child.

  • 12 months to < 2 years (Nimenrix)
  • 2 years to 5 years (Menveo)

The vaccination can be given with other scheduled vaccines or 4 weeks following during a separate appointment. It is also important to be aware that the vaccination provides clinical protection for approximately 3-5 years in a healthy child and therefore not life-long. This feature is relevant in today’s climate, where overseas travel can be a common occurrence, particularly if travelling to countries which experience endemic Meningococcal disease.

Existing program targeting 15 to <20 year old
The meningococcal program (Men ACWY) targeting children/young adults in the 15 to <20 year age groups continues to be funded by WA state government. Originally, part of the school-based vaccinations ending in December 2017, the program has been continued in 2018 with an unspecified end date. Children/young adults who have not yet received their 1 dose and fit into the age-range are able to access this vaccine from their GP. This is also a free Government funded vaccination, as long as the age criteria is met.

Meningococcal ACWY for year 10 students
Year 10 students are another population group who are eligible for the MenACWY vaccine in 2018. This vaccine (Menveo) will be given as part of the school based vaccination programs given in schools by a community health nurse. Look out for a consent form which will be sent home with your child. This form needs to be signed by a parent or guardian prior to a nurse administering the vaccination.

What if I don`t fit into any of these age groups?
The programs mentioned above are WA State Government funded vaccinations, meaning they are free if you fit within the age criteria. However, if you fall out of the age range, it doesn`t necessarily mean that you are unable to receive these vaccinations. However, there may be additional doses required particularly in young infants and most likely be a cost involved. For additional information to determine whether you are able to receive this vaccine, discuss with your local GP.

Meningococcal serotype B
The vaccine which protects against serotype B was launched in Australia in 2014 (Bexsero). This vaccine is currently not subsidised by the Government, but is available through private script at your local GP practice. It would be recommended to ring ahead prior to your appointment to ensure they have the stock available. In Western Australia in 2017, approximately 26% of the total cases diagnosed were attributable to serotype B (12/46).