Meningococci: symptoms and treatment

How are meningococci transmitted?

Meningococci are transmitted via droplet infection, i.e. coughing or sneezing, and direct close contact, for example kissing. The pathogens die off quickly in the air, so that infection is not possible with normal everyday contacts. There are different subspecies of meningococci. Bacteria subspecies A, which causes epidemics, mostly occurs in tropical areas. In Europe, cases of illness are more likely to be caused by subgroups B (68 percent) and C (22 percent). The incubation period is 1 to 10 days.

What diseases can meningococci cause?

Infection can lead to inflammation of the meninges (meningococcal meningitis) or bacterial blood poisoning (so-called meningococcal sepsis). In some cases, both diseases occur at the same time. Meningitis occurs in around 70 percent of cases, more than a third suffer from blood poisoning and in eight percent of cases there is a mixed form of both diseases (2005).

Every year around 700 people in Germany fall ill, around 50 die from it. In some cases, mental disabilities or paralysis remain. Meningococcal meningitis has become relatively rare in industrialized nations. In developing countries, however, it is one of the most common diseases. Especially in the “meningitis belt” of Africa, south of the Sahara and north of the equator from the east to the west coast, as well as in South America and Asia.

The pathogen occurs naturally in 5-10% of the population in the nasopharynx without causing any symptoms. Also, only a small proportion of those infected become ill. It seems that there must be a certain immune deficiency in order to develop meningitis. Although antibiotics are effective in combating the meningococci, the therapy must be carried out very quickly in order to avoid complications. Only a few hours decide the fate of the patient.

Signs of meningitis caused by meningococci

• Flu-like symptoms
• sensitivity to light
• neck stiffness
• Fever
• nausea
• Punctual skin bleeding
• headache
• vomiting and diarrhea

Initially, flu-like symptoms appear briefly. This is followed by sudden severe headaches, high fever, nausea, sensitivity to light and stiff neck. In a large proportion of those affected, small, punctate skin bleeding also occurs. In infants and young children, the symptoms are often more difficult to interpret. If a child has a fever, screams shrill, is very restless or noticeably lethargic, refuses to eat and may vomit or has diarrhea and is sensitive to touch, a doctor’s office or the nearest hospital should be consulted immediately.

treatment of meningitis

Even if there is only a suspicion of meningitis and the pathogen has not yet been clearly identified, patients with bacterial meningitis are treated with antibiotics immediately after the blood and cerebrospinal fluid is taken. Doctors usually use a combination of several antibiotics (such as cephalosporins and ampicillin).

Once the causative agent of meningitis is known and its sensitivity to antibiotics has been tested, treatment can be continued with just one appropriate drug. In some cases, the doctors also administer a cortisone preparation to prevent brain swelling.

Sick people should be treated urgently in the hospital, and care in the intensive care unit is often necessary. During the first few days, patients are isolated to prevent further contamination. Once antibiotic therapy takes effect, meningitis is no longer contagious.

It is also important to clean up the source of infection, provided the person concerned has not contracted the disease from another person suffering from meningitis. For this reason, an ENT doctor first looks for inflammation, then also in the chest and abdomen. Abscesses, sinus or mastoid inflammation are surgically removed as quickly as possible.

Vaccination against meningococci

Vaccination against meningococci has been recommended by the Standing Committee on Vaccination (STIKO) of the Robert Koch Institute since July 2006 for all children from the age of two. Children vaccinated after their first birthday receive a vaccine for lifelong immunization protection. The same applies to young people and adults. If the vaccination against meningococci has not taken place within the recommended period, a catch-up vaccination up to the age of 17 is recommended. Children who are vaccinated at the age of two to three months receive two vaccinations at least two months apart and a booster vaccination in the second year of life.