Meningitis B

What is meningitis B?

Meningococcal disease is a serious disease caused by the bacterium Neisseria meningitidis.

Approximately 10-20% of the general UK population carry the bacteria at the back of their nose and throat. Carriers do not have symptoms but can develop the disease when the bacteria invade the bloodstream from the back of the nose and throat. Rarely it can progress to septicaemia (blood poisoning) or meningitis (infection of the lining of the brain).

There are 12 different types of N. meningitidis and out of these, 6 are responsible for the majority of invasive disease: A, B, C, W, X and Y.1

Meningococcal group B bacteria are responsible for more than 90% of menincococcal infection in children. MenB vaccine is recommended as part of the childhood vaccination programme for babies. 2

The following is a summary about the disease. For further details speak to your local pharmacist or GP.

How is Meningitis B spread?

Meningococcal infection is spread through tiny droplets when coughing or sneezing by infected individuals or individuals who carry the bacteria but are not ill themselves.  The infection can also spread through kissing, sharing food/drink and contact through utensils, cutlery and toothbrushes.1

Which countries are at risk from meningitis B?

Meningococcal disease occurs worldwide. The highest rates of disease occur in the ‘meningitis belt’ of sub-Saharan Africa typically during the dry season. The full list can be found here.3

What are the signs and symptoms of meningitis B?

Typically, the incubation period for meningococcal disease is 2-7 days. Symptoms of invasive meningococcal disease  that lead to meningitis and/or septicaemia can cause:

  • Fever
  • Headache
  • Stiff neck
  • Non-blanching rash (does not disappear when a glass is pressed on the skin)
  • Light sensitivity (photophobia)
  • Altered mental state/consciousness
  • Severe muscular and joint pains
  • Vomiting and diarrhoea
  • Seizures
  • Coma

The symptoms can appear in any order and not everyone develops the more common signs and symptoms associated with meningococcal disease.

Presentation in children

Children and young people with the more specific symptoms and signs are more likely to have bacterial meningitis or meningococcal septicaemia and the symptoms and signs may become more severe over time.

Early features to watch for in children:

  • Leg pain
  • Thirst
  • Diarrhoea
  • Abnormal skin colour
  • Breathing difficulty
  • Cold hands and feet

Classic features (develop later)

  • Non-blanching rash: early on, the rash may be nonspecific or absent. By the time the rash develops, the person may already be very ill. Therefore seek medical assistance at the earliest opportunity.
  • Neck stiffness or pain
  • Light sensitivity

Late features:

  • Confusion or delirium
  • Seizures
  • Unconsciousness4

What are the complications of meningitis B?

Some of the most common complications associated with meningitis B are:

  • Hearing loss
  • Recurrent seizures (epilepsy)
  • Problems with memory and concentration
  • Co-ordination, movement (walking difficulty) and balance problems
  • Cognitive impairment, learning difficulties and behavioural problems
  • Vision loss, which may be partial or total
  • Loss of limbs – amputationis is sometimes necessary to stop the infection spreading through the body and remove damaged tissue
  • Chronic kidney disease
  • Skin complications (including scarring)4

What is the treatment for meningitis B?

If meningitis B is suspected then seek medical assistance urgently.

The main distinguishing feature is a non-blanching rash but it does not appear in some cases. Other symptoms include high fever and stiff neck. Refer to “What are the signs and symptoms of meningococcal disease?” section for more details.

A full list of signs and symptoms can also be found here.5

What advice is there for travellers?

Travellers who may be at higher risk include:

  • Travellers visiting areas within the meningitis belt of Africa or to an area where a known outbreak is occurring
  • Long stay travellers who have close contact with the local population
  • Backpackers
  • Travellers visiting remote areas with delayed access to high quality medical care

Travellers are advised to:

  • Practice good hand hygeine
  • Avoid sharing drinks and eating utensils (activities that require exchange of respiratory secretions)
  • Avoid over crowded and confined area

When to consider vaccination

The MenB vaccine is recommended to babies as part of their part of their childhood vaccination programme at age:

  • 8 weeks
  • 16 weeks
  • 1 year (booster)6

Vaccination

The MenB vaccine is made from proteins found on the surface of the meningococcal bacteria. They stimulate the immune system to produce antibodies to protect against future exposures to meningococcal bacteria.

The MenB vaccine is likely to cause fever in babies within 24 hours of the vaccination. It is important to give the baby liquid paracetamol after the vaccination to reduce risk of fever.

References

This information is taken from trusted third party websites, NaTHNaC (Travel Health Pro) and EMIS (Patient info) and use of all information has been licenced under the Open Government Licence http://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/.

Although the materials are being used/replicated under the provisions of the Open Government Licence this in no way represents endorsement of Traveljab.co.uk by NaTHNaC, Emis, Public Health England, the NHS or the Department of Health and Social Care

References:

  1. Travel Health Pro: National Travel Health Network and Centre (NaTHNaC)
  2. NHS: MenB vaccine overview
  3. World Health Organsation (WHO): Meningococcal meningitis, countries or areas at high risk, 2017
  4. Patient.info: Meningococcal disease
  5. NHS: Meningitis Symptoms
  6. The Green Book: Chapter 22 Meningococcal

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