What is meningococcal disease? The bacteria Neisseria meningitidis causes a range of illnesses that can rapidly progress to be fatal if not immediately recognized and treated. Meningitis is an infection of the lining of the brain that can cause coma, sepsis and death. Early symptoms start like the flu- fever, headache, body aches, and possibly nausea and vomiting, then the headache progresses in severity, the neck becomes very stiff and painful, and the person may become confused or even unconscious. A very specific RASH can alert clinicians to this dangerous disease- it is dark red/purple and does not whiten if pressed upon. This rash is caused by leakage of blood vessels as the bacteria releases toxins into the blood stream. Survivors of a severe meningococcal infection may have lost fingers, toes or even limbs as a direct result of this blood vessel damage.
Meningococcal disease is especially noteworthy here in Texas, where we were the first state to pass legislation to require the meningococcal vaccine for every college student. Sadly, this legislation came after one student at Texas A&M died (Nicolis Williams) in 2011, and a University of Texas sophomore (Jamie Schanbaum) had lost both legs, fingers, and narrowly survived meningococcal infection. The Texas law is named for both of these students. Jamie has remarkably gone on to not only champion efforts to educate about vaccine prevention for meningococcal disease, but to win a gold medal in the paralympics.
Who needs this vaccine? The meningococcal vaccine has NEW RECOMMENDATIONS- all adolescents should still receive their first shot (the MCV4) at age 11-12, as previously recommended, but now we know they need a BOOSTER DOSE at or after age 16, before they head off to college. Although initially thought to offer protection for a decade, it turns out that the immunity begins to wane in this age group after 5 years. Yes, they still needed that earlier vaccine to protect against the herds of kids joining them in close quarters at school and summer camp, but we want them maximally protected as well when they move into that dorm!
In addition, military recruits (also living in crowded quarters like a dorm) and anyone who has had their spleen removed should get this vaccine. Travelers to sub-Sahara Africa during the dry season are also at increased risk, so vaccination is recommended for this group as well.
BOTTOM LINE: Protect your adolescent against this rapidly progressive, dangerous disease by making sure they received not only their initial vaccine at 11-12 years, but also their BOOSTER before they head off to college! (If they are already in college but missed their booster, add this to their holiday wish list...)
Image above from NY Times
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