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Dr. Pramod Narula, chairperson of the Department of Pediatrics at New York Methodist Hospital in Brooklyn, discusses what parents need to know about meningococcal disease and its vaccine.
Q: A health official visiting my child's middle school recommended that students receive the meningococcal vaccine. Is meningococcus dangerous?
A: Meningococcal disease is an uncommon but serious infection caused by the bacterium Neisseria meningitidis (meningococcus). Meningococcus can cause meningitis (inflammation of the lining of the brain) or septicemia (an infection of the bloodstream). The bacterium is spread through the exchange of respiratory and throat secretions that occurs during intimate contact such as kissing, sharing food or beverages, or staying in the same room for more than four hours per day.
Meningococcal bacteria are very dangerous because they rapidly produce large quantities of endotoxin, a poison that damages small blood vessels and causes low blood pressure and shock. The disease is so unbelievably rapid that a child can die within four to six hours of contracting the infection. About one in every 20 children with meningococcal meningitis dies from the infection. The risk of infection is highest among infants less than 1 year of age, and much lower for children between the ages of 4 and 15.
However, at around 15 years of age the incidence of meningococcal disease rises. Although adolescents are less likely than infants to be infected, they are more likely to die from the disease. Symptoms of meningococcal meningitis include a stiff neck, headache, and high fever. If the infection is concentrated in the blood, symptoms include low blood pressure, rash, chills, and dark-purple spots around the arms and legs.
In 2005, the Centers for Disease Control (CDC) recommended that children 11-18 years of age receive a new meningococcal vaccine, Menactra. Unlike its predecessor Menomune, Menactra does not require a booster shot every three to five years. Both vaccines protect against four of the five types of meningococcal disease (A, C, Y, and W-135), including two of the three most common in the United States. However, neither Menomune nor Menactra protect against meningococcus type B, which is responsible for two-thirds of all meningococcal disease in infants.
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Pramod Narula, M.D.
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