Disease information

• Meningitis is an inflammation of the membranes surrounding the brain and spinal cord. Septicaemia is a form of blood poisoning. Meningitis and septicaemia can be caused by many different infections, but most cases of bacterial meningitis in the UK and Ireland are caused by meningococcal disease. Meningitis and septicaemia have different sets of symptoms and may occur separately or together.
• The scientific name for meningococcal bacteria is Neisseria meningitidis.

Why is septicaemia important?

• Of the two forms, septicaemia is more dangerous. While fewer than 5% of people with meningococcal meningitis die of the disease, the death rate for meningococcal septicaemia is around 20%, rising to 50% or more if the patient goes into shock before they get medical help. Most deaths from meningococcal infection are caused by septicaemia.
• About 50% of people with meningococcal infection get both meningitis and septicaemia, while over 30% get septicaemia alone and fewer than15% get meningitis alone.
  

How do you get meningitis and septicaemia?

• One in ten of us, at any time, are carrying the bacteria which cause meningococcal meningitis and septicaemia. We pass them between each other by regular, close, prolonged contact. Most of us can carry these bacteria without getting ill. But, in a very few people the bacteria overcome the body’s immune defences and get into the blood stream, causing meningitis and septicaemia.
• Septicaemia happens when bacteria in the blood multiply and produce toxins, making the person feel ill and feverish.  These toxins attack the walls of blood vessels so that blood leaks out.  Blood leaking out under the skin causes the non-blanching rash typical of meningococcal septicaemia.  As more blood is lost in this way, the circulatory system begins to shut down, causing other symptoms of septicaemia, such as cold hands and feet and rapid breathing.  Unless this process can be reversed by medical treatment, the person will go into shock, leading to heart failure or multiple organ failure and death.
• In people who develop meningitis, bacteria cross from the blood into the membranes surrounding the brain.  Bacterial toxins cause inflammation of tissue around the brain, producing symptoms of meningitis such as headaches, stiff neck, dislike of bright lights and drowsiness.  Without life saving treatment, the final result is coma and death.
• Although common, the bacteria are extremely fragile and not very contagious.  They are passed on mostly by prolonged close contact such as kissing and much less effectively by coughing and sneezing and less intimate contact.  They do not survive outside the body.
• We do not catch them from places or things like crockery, toys or clothing because they do not linger on surfaces or in the air.

The changing pattern of meningococcal disease

• Meningococcal bacteria can be divided into a number of groups including A, B, C, 29-E, W-135, X, Y, and Z.  In recent years Group B has caused up to 83% of cases in the United Kingdom and Republic of Ireland, with the remaining cases caused by Group C and more rarely by the other groups listed.  Now that Men C vaccine is available, providing effective protection against Group C meningitis and septicaemia, this strain of the disease has declined dramatically. Meanwhile, cases of Group B are unchecked.
• Group W135 is rarer than other forms, but since 2000, when there were Group W135 outbreaks in Africa, and amongst visitors to Mecca on the Hajj pilgrimage, cases in the UK rose to over 100/year.  However, now that the quadrivalent vaccine against A, C, W135 and Y meningococcal disease is a visa requirement for pilgrims to Mecca, Hajj - associated cases have decreased.  Group A meningococcal infection is almost unknown in the UK and Ireland, but is prevalent in sub-Saharan Africa.
• Within each year there are more cases of meningitis and septicaemia in winter, and over a period of years the disease has a cyclic pattern with peaks when the disease becomes more prevalent and troughs when it becomes more rare.  A peak occurred at the end of the 1990s, but with the introduction of  MenC vaccine  in the UK in 1999 and in the Republic of Ireland in 2000, Group C cases are in decline.
• Currently, cases of meningococcal meningitis and septicaemia occur at an incidence of about 1.3 cases per 30,000 people per year in the UK.  The incidence is somewhat more in the Republic of Ireland.
• Most of these cases are isolated events and are not linked to other cases.  Local outbreaks of meningitis and septicaemia occur from time to time, but most are of short duration.  In the past, outbreaks have most often been associated with Group C infection, but with the success of Men C vaccine, this is much less frequent.

Who is at risk?

• Although the risk of contracting meningitis and septicaemia is very small, infection rates are highest in children under the age of five, and there is a second rise in infections in the 15 to 24 age group.
• Scientists do not yet fully understand why some people are more susceptible to meningococcal infection, and this is an area in which Meningitis Research Foundation is funding research.
• When a case of meningitis or septicaemia occurs, close family contacts and others who have recently had very close contact with the patient are at slightly higher risk of getting the illness.  The Public Health doctor will make sure that anyone who is at risk is contacted and antibiotics may be given.  The antibiotics kill any bacteria which they may be carrying in their nose or throat.  However, if the bacteria have moved from the nose and throat into the blood stream, this type of antibiotic will not kill them.  So, even if you are given this medicine it is important to watch out for the signs and symptoms.

What is the best defence against meningitis and septicaemia?

• A vaccine against group C meningococcal meningitis and septicaemia is part of routine immunisation programmes in the UK and Ireland.  Although it is very effective, it cannot prevent other kinds of meningococcal disease.  In the absence of a universally effective vaccine it is important to be aware of the symptoms of meningitis and septicaemia to protect ourselves and others from this infection, because prompt treatment provides the best chance of a full recovery.
• See the symptoms of both meningitis and septicaemia are presented by clicking  here .  It is important to recognise that septicaemia has different symptoms than meningitis.  A person with septicaemia may never experience headache, stiff neck or aversion to light.
• The early signs of septicaemia are non-specific and similar to those of flu and other viral infections.  This makes diagnosis very difficult.  However, a person with meningococcal septicaemia will get severely ill, usually very quickly.
• The single most specific and most noticeable symptom of septicaemia is a non-fading rash.  The rash occurs in most cases of meningococcal disease, but sometimes does not develop until the disease is quite advanced.

Can meningitis and septicaemia be treated?

• Penicillin and other antibiotics can kill meningococcal bacteria in the blood or in the fluid around the brain.  Early recognition of meningococcal disease and prompt treatment with antibiotics greatly improves chances of survival.

Page last updated 04.05.07