13 September 2017

Meningococcal disease in an adult

The Department of Health today reported that a middle-aged adult is recovering in hospital after being diagnosed with serogroup Y meningococcal disease.

There have now been six cases of meningococcal disease notified in West Australians in the past month, including four serogroup W and two serogroup Y cases. Meningococcal disease usually occurs more commonly in winter and spring and the recent cases, who are not linked, serve as a reminder of the increased risk at this time of the year.

The Department of Health has identified the close contacts of all recent cases and provided them with information, and, where appropriate, antibiotics and a vaccine. This is to minimise the chance of further spread of the organism to others, should one or more of the contacts be carrying the strain that caused disease.

Meningococcal disease is an uncommon, life-threatening illness caused by a bacterial infection of the blood and/or the membranes that line the spinal cord and brain, and occasionally of other sites, such as the throat or large joints.

The incidence of the disease has decreased significantly in WA – down from a peak of 86 cases in 2000 to a low of 16 cases in 2013 – but now appears to be increasing again due to the emergence of new virulent strains of serogroup W, and to a lesser extent serogroup Y, meningococcal bacteria.

Overall, 23 cases were reported in 2016, and there have been 22 cases to date in 2017, comprising twelve serogroup W, four serogroup Y, four serogroup B, and one serogroup C infection, along with a case in which the type could not be determined. Twelve serogroup W cases is well above the long term average of less than one case per year and follows the record of 14 cases last year.

Meningococcal bacteria are carried harmlessly in the back of the nose and throat by about 10-20 per cent of the population at any one time. Very rarely, the bacteria invade the bloodstream or tissues and cause serious infections.

Meningococcal bacteria are not easily spread from person-to-person. The bacterium is present in droplets discharged from the nose and throat when coughing or sneezing, but is not spread by saliva and does not survive more than a few seconds in the environment.  

Invasive meningococcal infection is most common in babies and young children, and older teenagers and young adults, but infection can occur at any age.

Symptoms may include high fever, chills, headache, neck stiffness, nausea and vomiting, drowsiness, confusion, and severe muscle and joint pains. Young children may not complain of symptoms, so fever, pale or blotchy complexion, vomiting, lethargy (blank staring, floppiness, inactivity, being hard to wake, or poor feeding) and rash are important signs.

Sometimes – but not always – symptoms may be accompanied by the appearance of a spotty red-purple rash that looks like small bleeding points beneath the skin or bruises.

Although treatable with antibiotics, meningococcal infection can progress very rapidly, so it is important that anyone experiencing these symptoms seeks medical attention promptly.

With appropriate treatment, most people with the disease recover, although around 5 per cent will die and around 15 per cent may experience complications such as hearing loss, or gangrene requiring skin grafts or amputations.

A vaccine to protect against the serogroup C type of meningococcal disease, which in the past was responsible for around 15 per cent of cases in WA, but is now very rare, is provided free to children at 12 months of age. A vaccine against serogroup B meningococcal infection, historically the most common type in WA, is available on prescription. Combination vaccines are also available that protect against four types of the organism (serogroups A, W and Y, in addition to serogroup C).

As a result of the increase in serogroup W disease in WA over the past three years, a funded state-wide meningococcal ACWY vaccination program for adolescents aged 15 to 19 years commenced this year, and most of those eligible are receiving vaccine at school during the third term. Eligible teenagers who are no longer at school can currently receive the vaccine at community health clinics and some university student health centres. The vaccine will also be available at GP clinics from late September.

Details of where 15-19 year-olds can access the free meningococcal ACWY vaccine are available at HealthyWA (external site)

ENDS

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