What is meningococcal disease?
Meningococcal disease is a rare but very serious illness that usually appears as meningitis or septicaemia. Meningococcal disease is caused by bacteria called ‘meningococci’. There are a number of different strains (or serogroups) of meningococci.
Although meningococcal disease is uncommon, it can develop very quickly and can be fatal in 5-10 % of cases. Most people make a complete recovery if the infection is diagnosed early and antibiotic treatment commenced promptly. The early signs of the disease can look like other milder illnesses, so sometimes it is hard to diagnose early.
Around 10-20 % of people carry Meningococci bacteria at the back of the nose and throat without showing any illness or symptoms. Some people who come into contact with Meningococci become sick. It is not usually clear why a particular person becomes sick instead of becoming a carrier.
Who catches meningococcal disease?
Meningococcal disease can occur at any age, but babies and children less than five years of age, young adults aged 15–24 years and people with immune system suppression are at greatest risk.
How is meningococcal disease spread?
The disease is difficult to spread and is associated with regular close, prolonged and intimate contact. The bacteria are passed between people in the secretions or fluid from the back of the nose and throat.
If a case of meningococcal disease occurs, people who live in the same household, sexual and other intimate contacts, and close contacts in residential accommodation, such as student boarding houses and military camps, are at greater risk of infection.
What is covered currently in the Australian Immunisation Schedule?
Since 2003 a vaccine for the Meningococcal serogroup C has been part of the standard childhood schedule, administered to children at 12 months of age. As a result, the overall incidence of Meningococcal disease has decreased significantly in WA during the past decade, with about 20 cases now reported each year, down from a peak of 86 cases in 2000.
What is the relevance of the Meningococcal serogroup W?
Until recently, serogroup B had become the most common cause of Meningococcal disease in Australia. In WA and nationally Meningococcal serogroup W has been increasing annually since 2013, with one case notified in that year in WA compared to 14 cases in 2016 (of a total of 22 Meningococcal cases) and it is now the most prevalent serogroup in WA. Many Meningococcal W cases identified in Australia have been associated with a high case fatality and unusual clinical presentations, making early diagnosis more challenging for doctors.
Who can access the Meningococcal serogroup W vaccine?
In late January the WA government announced a state-wide Meningococcal serogroup W vaccination program which targets 15-19 year olds, as this group has the highest rates of carrying the Meningococcal bacteria. The vaccine covers the A, C, W135 and Y serogroups. After initial access via schools and university health centres, it is now available free under the state government program from GPs on Bayview for all persons aged 15-19 years.
It is important to note that while the program will continue in in 2018 and 2019, only students in year 10 will be eligible, regardless of age. So, access for the current 15-19 year age group is only available until 31 December 2017.
Patients are protected approximately 1 month after receiving the vaccine dose and protection then lasts approximately 5 years. The immunisation does not contain live bacteria, so it cannot cause Meningococcal infection. The vaccine doesn’t specifically cover serogroup B, which is available through a separate vaccine, Bexsero. It is considered a safe and well tolerated vaccine. The same vaccine is currently given to all first year college students in the USA. Potential side effects include pain, redness and swelling at the injection site, fever, irritability, drowsiness, decreased appetite and headaches.
The appointment associated with receiving the vaccine at GPs on Bayview is bulk billed. Please inform receptionists the purpose of the appointment at the time of booking, to ensure adequate vaccine stocks at the time of the appointment.
Australian Government Department of Health, Australian Immunisation Handbook, 30 August 2016 Available from: http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home~handbook10part4~handbook10-4-10 [13 January 2017]
Australian Government Department of Health, Meningococcal W, 20 December 2016 Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-meningococcal-W.htm [13 January 2017]
Government of Western Australia Department of Health, Meningococcal ACYW Statewide Vaccination Program, 31 August 2017 Avilable from: http://ww2.health.wa.gov.au/Articles/J_M/Meningococcal-ACWY-Statewide-vaccination-program [7 September 2017]
Centers for Disease Control and Prevention, Meningococcal Disease – Community Settings as a Risk Factor, 22 October 2015 Available from: https://www.cdc.gov/meningococcal/about/risk-community.html [13 January 2017]
