Invasive meningococcal disease in Victoria

Key messages

• Meningococcal disease is an uncommon but serious bacterial infection that requires urgent medical care to prevent death or disability.
• Young children, adolescents, young adults and people with a weakened immune system are most at risk.
• Respiratory tract infections and smoking increases the risk of meningococcal disease.
• The bacteria that cause meningococcal disease can spread from person-to-person through close, prolonged or intimate contact.
• Stay up to date with recommended vaccinations to protect against meningococcal disease.
• Meningococcal disease is an “urgent” notifiable condition in Victoria and must be notified to the Department of Health by clinicians as soon as practicable by calling 1300 651 160.

What is the issue?

Meningococcal disease is an uncommon but serious illness caused by infection with meningococcal bacteria, also known as meningococcus or Neisseria meningitis. People with meningococcal disease can become very unwell within a few hours and it can lead to death or disability. Early diagnosis and treatment are critical.

In Victoria, meningococcal disease occurs more often in winter and spring. Respiratory tract infections and smoking also increase the risk of meningococcal disease.

As of 8 June 2023, there have been 7 total cases of meningococcal disease, including 2 deaths, reported in Victoria this year. Cases have ranged from an infant aged 1 year to an elderly person in their 90s. Most cases were aged between 15 to 20 years old, and their illnesses were due to meningococcal bacteria serogroup (strain) B.

It can spread from person-to-person through close, prolonged or intimate contact, such as between household members and intimate partners and are not easily spread by sharing drinks or food. It is recommended not to share e-cigarettes (vapes) or cigarettes.

Who is at risk?

Meningococcal disease can affect people of all ages, but certain groups are at increased risk, such as:

• Infants and young children, particularly those aged less than 2 years.
• Adolescents and young adults aged between 15 to 24 years.
• Close contacts of someone with meningococcal disease, such as household members or intimate partners.
• People who have not been vaccinated against meningococcal disease.
• People with a weakened immune system.
• People who smoke.
• People with recent respiratory tract infections, such as influenza and COVID-19.

Symptoms and transmission

Symptoms of meningococcal disease can include fever, chills, feeling generally unwell, headache, neck stiffness, light sensitivity, nausea, vomiting, rash of red-purple spots or bruises, joint or muscle pains, confusion, and reduced consciousness.

In infants and young children, symptoms can also include being irritable or unsettled, high-pitched crying, reduced feeding, pale or blotchy skin, tiredness and drowsiness.

Meningococcal bacteria can spread from person-to-person through contact with infectious respiratory droplets or nose and throat secretions. This can occur through close, prolonged, or intimate contact, such as between household members and intimate partners.

Some people carry meningococcal bacteria in the nose and throat without developing illness. This occurs more frequently in adolescents and young adults who can potentially spread the bacteria to others.

Recommendations

For the public

• Anyone who develops symptoms of meningococcal disease should seek urgent medical care.
• Stay up to date with recommended vaccinations to protect against meningococcal disease. Vaccines are available free to eligible people under the National Immunisation Program.
  • Meningococcal ACWY (Men ACWY) vaccine is available free to infants at 12 months, adolescents and people with certain medical conditions.
  • Meningococcal B (Men B) vaccine is available free to Aboriginal and Torres Strait Islander children up to the age of 2 years and people with certain medical conditions.
• These vaccines are available to anyone from 6 weeks of age to reduce the risk of meningococcal disease. They can be prescribed by your doctor, however, there may be an associated fee. Certain people at increased risk of meningococcal disease are strongly recommended to receive Men ACWY and B vaccines:
  • Young children aged less than 2 years.
  • Aboriginal and Torres Strait Islander people aged 2 months to 19 years.
  • Healthy adolescents and young adults aged 15 to 24 years, particularly those who are current smokers OR who live in shared residential accommodation, such as dormitories, boarding schools or military barracks.
• Protect against respiratory tract infections by staying up to date with recommended vaccinations, such as seasonal influenza and COVID-19 vaccines.

For clinicians

• Consider meningococcal disease in patients with compatible illness. If meningococcal disease is suspected:
  • Request cultures and PCR testing of blood, CSF or other sterile sites as clinically appropriate. PCR testing is arranged by the primary pathology service through the Microbiological Diagnostic Unit.
  • Commence empirical treatment for bacterial meningitis (as per the current edition of Therapeutic Guidelines) without delay.
• Meningococcal disease is an urgent notifiable condition that must be notified to the Department of Health upon initial diagnosis or clinical suspicion as soon as practicable and within 24 hours on 1300 651 160.