Causative bacterium

Meningococcal disease occurs as a result of a systemic bacterial infection by Neisseria meningitidis. Meningococci are gram-negative diplococci divided into serogroups. There are at least 13 serogroups, of which groups B, C and Y are historically the most common in the UK.

Meningococcal infection most commonly presents either as meningitis or septicaemia, or a combination of both. Less commonly, individuals may present with pneumonia, myocarditis, endocarditis, pericarditis, arthritis, conjunctivitis, urethritis, pharyngitis or cervicitis.

The incubation period

The incubation period is from two to seven days and the onset of disease varies from sudden and severe with acute and overwhelming features to slow and gradually worsening symptoms.

Early symptoms include malaise, pyrexia and vomiting. Use the ‘Symptoms Checker’ below to rollover and reveal meningitis C, symptoms and signs.

The information outlined above reflect current NHS Choices recommendations

In meningococcal septicaemia, a rash may develop, along with signs of advancing shock and isolated limb and/or joint pain.

The rash may be non-specific early on but as the disease progresses the rash may become red or purple and may not whiten when pressure is applied. This can readily be confirmed by gently pressing the area with a glass tumbler (the ‘Tumbler Test’) when the rash can be seen to persist.

The incidence of meningococcal disease is highest in infants under one year of age, followed by children aged one to five years. The next highest incidence is seen in young people aged 15 to 19 years.

Overall mortality remains around 10% in the UK. Mortality is higher in cases with septicaemia than in those with meningitis alone. Studies in paediatric intensive care units have indicated that prompt and active management may reduce fatality ratios.

A prevention landmark

In November 1999, Meningitis C conjugate vaccine was introduced into the UK routine immunisation programme.

All children and adolescents under the age of 18 years were immunised over a two-year period.  In January 2002 - vaccination was extended to include all adults under 25 years of age.

Dramatic fall in meningococcal disease

Following the Meningitis C vaccine campaign, the number of laboratory-confirmed serogroup C cases fell by over 90% in all age groups immunised.

Another advantage of the vaccination was that cases in other age groups fell by approximately two-thirds as a result of reduced carriage rates and indirect protection (herd immunity) and therefore reduced risk of exposure.

• In 2006 - a booster dose (combined with Hib as Hib/MenC) was introduced into the infant immunisation programme at 12 months because protection against meningococcal group C wanes during the second year of life
• In 2009 - the number of cases was at an all time low of just ten

Points to remember

• The meningitis C vaccine does not protect against meningitis caused by other bacteria or by viruses
• Meningococcal group B is common in the UK

To check whether a patient may be at greater risk of developing meningitis C click here.

Did you know?

• Meningococci colonise the nasopharynx of humans and are frequently harmless commensals
• Between 5 and 11% of adults carry the bacteria without any signs of the disease
• Up to 25% of adolescents carry the bacteria without symptoms
• In the UK, large epidemics coincided with each of the two world wars