The Disease
Meningococcal meningitis is an acute bacterial disease characterised by sudden onset of fever, intense headache, vomiting and a stiff neck. A skin rash appears in the later stages of the disease and signifies severe illness. Although the disease is treatable with antibiotics, sufferers may become very sick or even die within hours of onset if not diagnosed promptly and correctly. The disease is transmitted from person-to-person by respiratory droplets ie coughing, sneezing etc. Extensive travel in crowded conditions or extended contact with the local population in crowded places are among the main risk factors.

Where is it found?
Meningococcal Meningitis occurs in all countries. In sub-Saharan Africa, epidemics of serogroup A meningococcal disease occur frequently during the dry season (December through June) particularly in the savannah areas extending from Mali eastward to Ethiopia, a region known as the ‘meningitis belt’. Epidemics due to serogroups A and/or C have also occurred in areas further south in Africa (Tanzania, Burundi, Angola) as well as in parts of Asia, in particular northern India, Nepal and Mongolia, again during the dry season (November to May). A complex range of risk factors cause epidemics.

Risk to travellers
The risk to travellers is generally low. Vaccination is recommended for travel to the ‘meningitis belt’ during the dry season, for travel to areas with an active epidemic, or for prolonged travel when extensive contact with the local population in endemic areas is expected.

NOTE - Meningococcal meningitis is a mandatory requirement for all travellers over three months of age travelling to Saudi Arabia for the Hajj.

Vaccination
Type (Travel):

• Polysaccharide ACYW₁₃₅ vaccine (Menomune/Mencevax)
• Conjugate ACYW₁₃₅ vaccine (Menactra/Menveo)

Standard Schedule:

• Mencevax/Menomune: A single dose provides three years protection. Not recommended for children under the age of 2 years.
• Menactra: 2-55 years of age/Menveo: 11 years and over. Protection for 5+ years.

Level of protection:

• ~90% effective.
• Effective against serotypes A, C, Y, W₁₃₅.
• Conjugate vaccine reduces carriage of bacteria in respiratory tract.

Type: (Domestic)

• Polysaccharide, conjugate (Meningitec/Menjugate/NeisVac-C)

Standard schedule:

• Age 6 weeks to 12 months: Three intramuscular doses administered at least 1 month apart.
• Children (over 12 months), adolescents and adults: A single intramuscular dose.

Level of protection:

• Adequate antibody response elicited against serogroup C in 98-100% of infants after third dose and after a single dose in adolescents and young adults.
• Effective against serotype C.

Possible side effects:
Usually infrequent and mild:

• Common: Redness and swelling around the injection site.
• Less common: Feeling unwell, headache, fever, lethargy.
• Rare: Wheezing, rash, sever local reactions.

As with all vaccines, there is a small risk of allergic reaction.

Meningitis in Australia
In Australia and other developed nations meningitis is mainly found in the form of serogroup C of Neisseria meningitidis.
The Conjugate C vaccine provides long-term immunity against this form of the disease. The vaccine provides active immunisation of children from the age of 6 weeks, and in adolescents and adults.

Infants - Data indicates that antibodies persist for at least 1 year following the three-dose schedule. An adequate serological response, defined as serum bactericidal antibodies (SBA) 1/8, was achieved in 91%of infants after 1 dose and 98-100% of infants 1 month after the third dose. There are currently no recommendations for boosting.

Adults - 99-100% of adults had an SBA response 1/8 after administraton of a single dose of vaccine.

More information on Meningococcal Meningitis is available during your pre-travel consultation with Travelvax. Call 1300 360 164 for the location of the clinic nearest to you.