Meningococcus Information for Ob-Gyns
10/29/14 FDA announced that it has approved the first vaccine to prevent serogroup B Meningococcal disease. Additional information can be found on the manufacturer’s press release.
Invasive meningococcal disease generally appears in one of three forms: meningitis, meningococcemia (blood infection), or pneumonia. The infection usually has an abrupt onset, with symptoms developing within 3–5 days. Even with proper antibacterial therapy, fatalities do occur. The over-all case fatality rate of invasive meningococcal disease is 9–12%. As many as 20% of individuals who contract meningococcal disease suffer serious, permanent damage, such as deafness, neurologic deficit, and limb loss. Meningococcal meningitis, a severe, acute inflammation of the lining that surrounds the brain and spinal column, is the most common presentation of invasive meningococcal disease. Sudden high fever, severe headache, and a stiff neck comprise the common trio of diagnostic symptoms for meningococcal meningitis, and may be accompanied by increased sensitivity to light, vomiting, altered mental status (confusion, drowsiness), and joint pain.
Meningococcemia. a bloodstream infection, may occur with or without meningococcal meningitis and is marked by fever; hypotension; multiorgan failure; and a macular rash, which may be either pinpoint small (petechial) or consist of larger purple hemorrhages in the skin (purpuric).
Several Neisseria meningitidis serogroups are endemic in the United States. Current vaccines protect against four of five serogroups of meningococcal disease: A, C, Y, and W135. Group A is found mostly in the African meningitis belt, which spans from Ethiopia to Senegal. Unfortunately, at this time, no vaccine offers protection against serogroup B. Overall, B, C, and Y each account for about 30% of cases; these numbers vary as much as 20% from year to year, as outbreaks are influenced by age and genetic factors. Type C is more common among older children and adults.
There are three vaccines available in the United States for meningococcal protection, preventing the same four strains of the disease. These vaccines are sometimes referred to as tetravalent vaccines. Menomune (Sanofi), which is also known as meningococcal polysaccharide vaccine (MPSV or MPSV4), has been available since the 1970s and is the vaccine recommended for persons older than 55 years and pregnant women who need protection from the disease. This polysaccharide vaccine appears to offer protection from 3–5 years.
The newer vaccines Menactra (Sanofi) and Menveo (Novartis), also known as MCV4, contribute to a reduction in the bacterial carriage in the nose and throat and a longer duration of immunity. MCV4 is licensed for people aged 2–55 years: (Menactra for ages 2–55 years; Menveo for ages 11–55 years).
A precaution to a meningococcal vaccine includes a moderate or severe acute illness with or without fever.
For more information about meningitis, read the CDC's Meningitis Disease section.
Last Updated: 8/2/2013
Meningococcus Information for Patients
Meningococcal meningitis is a serious bacterial infection of the protective coverings of the brain and spinal cord. It can cause high fever, headache, and stiff neck in just 1–2 days. It can also cause small, dark spots on the arms and legs, confusion, nausea, vomiting, and trouble looking into bright lights. This disease can cause death or serious long-term complications in about 25% of people who get the infection.
Getting a vaccine is the best way to prevent meningococcal meningitis infection. Recently, physicians have changed the recommendations for getting the vaccine. It is now given routinely for adolescents, preferably at age 11–12 years, with a booster dose at age 16 years. People at high risk for infection should get the vaccine in two doses, given 2 months apart. See below for high-risk groups.
There are three vaccines available that each prevents the same four strains of the disease. Menomune is a meningococcal polysaccharide vaccine (MPSV4) that has been available since the 1970s and is the vaccine recommended for people older than age 55 years and pregnant women who need protection from the disease. MPSV4 protects against infection for 3–5 years.
The newer vaccines Menactra and Menveo, also known as MCV4, protect for longer periods. Menactra is for people ages 2–55 years. Menveo is for people ages 11–55 years.
You should receive the MCV4 vaccine if:
You are an unvaccinated adolescent between ages 11–18 years
You are a college freshmen living in a dormitory
You are a military recruit
You have spleen problems or your spleen has been removed
You have complement deficiency
You are a microbiologist who works with Neisseria meningitidis (the bacteria that cause the disease)
Contact your health care provider if you qualify for the vaccine under the new recommendations.
Individuals should not receive any of the meningococcal vaccines if they have had a severe allergic reaction after a previous vaccine. MCV4 should not be given to pregnant women. MPSV4 is safe for pregnant women. Those with fever or serious illness should postpone getting the vaccine.
For more information about meningitis, read the Centers for Disease Control and Prevention's Meningitis section.
Last Updated: 8/2/2013