What is meningococcal disease? Illness explained as Virginia reports outbreak

There is a statewide outbreak of meningococcal disease in Virginia, according to health authorities.

On 30 August, the Virginia Department of Health (VDH) released a statement warning that 27 cases of the disease had been reported in eastern, central, and southwest Virginia in the past 14 months. This is three times higher than the expected number of cases during that time period, the statement said. Five people have died from complications of the illness.

Meningococcal disease refers to a group of illnesses, including meningitis, that are caused by Neisseria meningitidis, per the Centers for Disease Control and Prevention (CDC). These illnesses can be deadly, and they’re most common in children younger than one, teenagers and young adults ages 16 through 23, and adults 65 and older.

The strain of meningococcal disease currently circulating in Virginia is also spreading more widely across the US right now, the statement said. A common risk factor—that would explain why some people have contracted the disease and others haven’t—hasn’t yet been identified; however, most patients who have been affected in Virginia are Black or African American adults ages 30 to 60, the statement said.

The most common symptoms of meningococcal disease are fever, headache and stiff neck, but patients also often experience nausea, vomiting, confusion, and photophobia (which causes the eyes to become more sensitive to light). At first, it may be easy to mistake meningococcal disease symptoms for a flu-like illness, but they can quickly become more severe, per the VDH statement.

In the US, there are two different vaccines that provide protection against five different kinds of meningococcal disease. One protects against the A, C, W, and Y serogroups, while the other protects against serogroup B.

All children aged 11 to 12 should get the MenACWY vaccine, with a booster shot administered at age 16, per the CDC. The MenB vaccine should preferably be administered between ages 16 and 18.

All but one of the known patients in the Virginia outbreak was vaccinated—and, thus, protected—against the Y serotype, the statement said.

Some people are high-risk for meningococcal disease, including people with certain medical conditions—including HIV, functional and anatomic asplenia, and persistent complement component deficiencies—and people who take a type of medication known as a complement inhibitor. These are most often prescribed for certain types of blood disorders, generalised myasthenia gravis, and a disorder of the brain and spinal cord called neuromyelitis optica spectrum disorder. People who regularly spend time in certain settings, such as microbiologists who work with the bacteria that causes meningococcal disease, are also at an increased risk of contracting the illness.

Meningococcal disease is spread through prolonged contact with someone who has the illness, so the VDH is encouraging residents to follow certain precautions to lower their risk of getting sick. These include: avoiding close contact with people who are sick; practising good hand hygiene; and avoiding sharing personal items (like chapstick or toothbrushes).

Additionally, the VDH said parents should make sure their children are up-to-date on all available vaccines, including the MenACWY and MenB shots.

The VDH statement stressed the importance of seeking medical help immediately if you or someone in your family begins to experience symptoms of meningococcal disease. If it is caught early, antibiotics may be used to reduce the risk of death. Depending on the severity of illness, doctors may also recommend breathing support, medications for low blood pressure, wound care for damaged skin, and surgery to remove dead tissue.

Even with antibiotic treatment, 10 to 15 out of every 100 people with meningococcal disease will die, and as many as 20 per cent of survivors will suffer long-term complications like deafness, brain damage, loss of limb(s), and nervous system problems.