Student Living and Meningococcal Meningitis

Meningococcal meningitis can be a severe and potentially fatal infection. Every now and then we hear of outbreaks of meningococcal meningitis occurring at universities, high schools, or places where there are large gatherings. Despite available vaccines against meningococcal meningitis outbreaks continue to occur.

Why do outbreaks still occur? Are you at risk? Below we’ll tell you what you need to know about meningococcal meningitis and the vaccines to prevent it.

What is Meningococcal Meningitis?

Meningococcal meningitis is a severe infection of the blood and meninges (membranes that cover the brain and spinal cord) caused by the bacteria Neisseria meningitidis. There are 6 major serogroups of meningococcal: A, B, C, W, X, and Y.

Meningococcal is spread from person to person through close contact with an infected person’s saliva or respiratory secretions (e.g. by coughing, sneezing, or from objects freshly soiled with infected respiratory secretions).

Many healthy people can carry the meningococcal bacteria in their nose and throat without developing disease. Invasive Meningococcal Disease (IMD) develops when the bacteria invade the body and can be fatal. Symptoms can include sudden onset of headache, fever, rash, stiffness of the neck, nausea, vomiting, sensitivity to light, or altered mental status. About 10% of people with IMD will die, and up to a third of those who survive can be left with long term complications including hearing loss, neurological symptoms, and limb amputations.

Who is at risk?

The overall risk of IMD in Canada is generally low, with an average number of about 196 cases per year. Most of these cases occur between November and March. People at highest risk of developing IMD include:

• Children <5 years of age
• People living in crowded living quarters
• Adolescents 15-19years of age
• Travellers to areas where the disease is higher risk, such as the “meningitis belt” in Africa
• People with another respiratory tract infection (e.g. the flu)
• Smokers
• Those with HIV infection or other conditions that affect the immune system

 

Meningitis is spread through nose and throat droplets

Young children and adolescents are at higher risk of IMD. Meningococcal bacteria are spread through saliva or respiratory secretions from person to person, or from objects freshly soiled with respiratory secretions.  I can also be spread by secretions from healthy carriers of the bacteria. Normal infant and toddler behaviour increases exposure from sucking on objects contaminated with saliva. Adolescents are also at increased risk as they are more likely to be exposed to saliva from activities such as kissing, coughing, sneezing, and sharing contaminated items like drinks, cigarettes, lipstick, etc.  People living in crowded living conditions such as student dorms are also at increased risk of exposure.

Meningitis vaccines

The best way to prevent meningitis is to get vaccinated, especially for those who are at higher risk of developing IMD.

The vaccine for meningitis C was introduced into the routine vaccine schedule for infants and adolescents in 2003, and as such, the rates of meningitis C has decreased dramatically. In 2011 only 2% of IMD cases were caused by meningitis C. The majority of IMD cases in Canada are caused by meningitis B, followed by meningitis Y.

In 2016 the grade 9 meningitis C booster was replaced with the four-strain, quadrivalent vaccine, covering types A, C, Y, and W-135.  Those born in 2002 and later should have received this vaccine in grade 9 in BC. Protection from the quadrivalent vaccine lasts for 5 years if vaccinated at 7 years of age or older, and 3 years if vaccinated at 6 years of age or younger.

The quadrivalent meningitis vaccine is also provided free to individuals at high risk for invasive meningococcal disease including those with no spleen or an immune system disorder, those who have received a transplant, or those who have been in close contact with a person with meningococcal A,C,Y,W-135 disease. If you think you qualify for a free meningococcal vaccine contact your local public health unit: https://immunizebc.ca/finder#8/49.246/-123.116

The quadrivalent meningitis vaccine is also recommended but not provided free to:

• Travellers to the “meningitis belt” in Africa, or other countries experiencing outbreaks
• Pilgrims entering Saudi Arabia for Hajj or Umrah (the vaccine is required by the government of Saudi Arabia)
• Adolescents born prior to 2002 attending university who did not receive the vaccine in grade 9
• Research workers
• Military personnel

Meningitis B Vaccine – Bexsero

The meningitis B vaccine, Bexsero, is not part of BC’s routine vaccine schedule. The duration of protection from the Bexsero vaccine has not yet been established. The vaccine has been available since 2013 and is provided free to individuals who are close contacts of serogroup B invasive meningococcal disease. It is also recommended but not provided free to:

• High risk individuals 2 months of age and older including those with no spleen or an immune system disorder
• Research workers
• Military personnel
• Travelers to an area with an outbreak known to be caused by serogroup B
• Adolescents and university students up to 24 years of age

Bexsero vaccine schedule:

• Infants 2-5 months of age: 3 doses given 4 weeks apart with a 4^th dose after 12 months of age and at least 8 weeks after dose 3.
• Infants 6-11 months of age: 2 doses 8 weeks apart with a 3^rd dose after 12 months of age and at least 8 weeks after the 2^nd
• Children 12 months-10 years of age: 2 doses 8 weeks apart
• Individuals 11 years of age and older: 2 doses 4 weeks apart

Meningitis vaccines at TravelSafe Clinic

The four-strain quadrivalent vaccine and meningitis B vaccine are both available at TravelSafe Clinic. Call us at 604-251-1975 to arrange an appointment or to receive further information about the meningitis vaccines.