Meningococcal Invasive Disease
Meningococcal invasive disease is caused by bacteria called Neisseria meningitidis (N. meningitidis).
Although N. meningitidis is a very severe pathogen, it is not as contagious as viruses that cause the common cold or the flu. The bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been. N. meningitidis spreads from person to person either by direct contact with respiratory and throat secretions (e.g. kissing), indirect contact (e.g. sharing of eating utensils, toothbrushes), or by aerosol droplets (e.g. coughing and sneezing).
Symptoms of meningococcal invasive disease can be different depending on the type of infection the bacteria has caused. The most common symptoms are high fever, chills, drowsiness, and a rash. Symptoms of meningococcal meningitis may include headache, fever, and stiffness of the neck, sometimes accompanied by nausea, vomiting, visual sensitivity to light or mental confusion. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The infant may appear slow or inactive, have vomiting, be irritable, or be feeding poorly. The symptoms of meningococcemia (infection in the bloodstream) may include a sudden onset of fever and a rash of small purplish spots.
Complications of meningococcal invasive disease can result in permanent hearing loss, brain damage, loss of limbs, and death.
The following groups of people are at high risk for meningococcal invasive disease:
* Infants and young children
* International travelers to places where meningococcal disease is common
* Household contacts of people who are sick with meningococcal disease
* People who live in close quarters with others including military recruits and college students who live in dormitories
* Microbiologist who work with isolates of N. meningitidis
* People with a damaged or missing spleen
* People with an immune system disorder
* People exposed to tobacco smoke either directly or second hand
There is a vaccine that offers protection against four of the five most common serogroups of Neisseria meningitidis. The meningococcal conjugate vaccine and polysaccharide vaccine are available in the United States. For more information about the meningococcal meningitis vaccine call the Immunization Division at 1-512-776-7284.
Routine hand washing and practicing respiratory etiquette (e.g. covering mouth and nose while sneezing or coughing) is essential to prevent spread of bacteria. Avoid close contact with people who are sick, limit sharing food, eating utensils, and other personal belongings can also help stop the spread of bacteria.
School Exclusion Policy
Children with meningococcal meningitis should be kept out of school or childcare until they have written permission from a healthcare provider and until they are fever free for 24 hours without the use of fever suppressing medications. Rules for exclusion of sick children from school and childcare are outlined in the Texas Administrative Code, specifically Rule 97.7 for schools and Rule 746.3603 for childcare.
Recent Texas Trends
For the past ten years the number of meningococcal invasive disease cases for Texas has ranged from a high of 105 (0.5 cases per 100,000 population) in 2003 to 30 (0.1 cases per 100,000 population) in 2013.
Since 2008, 18.3% of reported invasive meningococcal cases occurred in the 60 and over age group, 14.7% in the 20 to 29 age group, and 11.5% in the under 1 age group. Of the 279 cases reported since 2008, 41 (14.7%) resulted in death.