What you need to know about meningococcal disease

Q. How do I get myself or my children immunised?

A. For school-age children, public health nurses will start administering injections in schools on August 2.

For children under five or those not attending school, the vaccine will be available from next Monday at various health care providers, including GPs or medical clinics, Maori or Pacific health services and Plunket.

Teenagers who have left school are not due to be immunised until next February. The vaccination is unavailable for anyone over 20.

Q. What is meningococcal disease?

A. Meningococcal disease is a serious infection caused by bacteria. It can cause septicaemia (a severe infection of the bloodstream) or meningitis (swelling of the membranes and fluid that cover the brain and spinal cord).

Meningococcal disease is commonly referred to as meningitis but meningitis can be caused by other bacteria.

The symptoms can develop very quickly and can lead to death within 24 hours or permanent disability such as deafness or disfigurement.

Q. What are the symptoms?

A. It can be hard at first to tell meningococcal disease from other illnesses such as influenza because many of the symptoms, such as headache and achy limbs, are similar. But meningococcal disease can get worse very quickly, which is why urgent medical care and antibiotics are needed.

A baby or child may have a fever, cry a lot, be unsettled, refuse food or drink, vomit, appear sleepy, floppy or harder to wake, have a rash or spots and dislike bright lights.

An adult may have a fever and headache, vomit, have a stiff neck and dislike bright lights, experience joint pain and aching muscles, be sleepy, confused, delirious or unconscious, have a rash or spots.

Seek medical help immediately for anyone with these symptoms and keep a close eye on their condition. For example, if they are sleeping, wake them frequently to check on them.

Q. How is the disease spread?

A. People can carry the meningococcal bacteria harmlessly in the back of their throat and nose without getting sick (it is estimated that one in five people carry the germ at some stage).

It is spread in droplet form - for example through coughing, kissing, sharing food or drink - but it is not highly contagious like whooping cough or chicken pox.

The biggest risk factor is living in overcrowded housing.

Dr Greg Simmons, medical officer of health for Auckland Regional Public Health, says most people's immune systems identify the germ, produce an immune reaction to stop it from invading and in the end "knock it off and it goes away. That is a normal infection".

But sometimes the germ penetrates the defences of the lining of the throat and the person becomes seriously ill. The reasons this happens to some people and not others are unclear.

Q. Who gets it?

A. Anyone can get meningococcal disease but rates among Maori and Pacific people are much higher.

On average Maori contract the disease at double the rate of Europeans. Those of Pacific origin are affected at four times the rate of Europeans.

But for all ethnic groups the rate of disease is particularly high among children under 5 - each year more than half the victims of meningococcal disease are in this age group.

Babies are most susceptible to the disease because their immune system is immature.

Q. How many people are affected by meningococcal in New Zealand?

Since 1991 when the outbreak began, more than 5400 people have become sick with the disease and 220 people have died. (About 400 cases and 16 deaths a year.) For every 100 people who get the disease, four will die and a further 20 will be left with some degree of serious disability such as brain damage, hearing loss, loss of limbs or damaged skin. Some will have learning or behavioural difficulties.

Vaccines already exist for other strains of the disease but are not widely used.

A. What is the vaccine made from and how does it work?

Dr Nikki Turner, director of the Immunisation Advisory Centre at Auckland University, says the meningococcal vaccine is not a "live" vaccine like that used for measles.

The meningococcal vaccine is made from a piece of protein from the outer membrane of the germ. The body recognises it as being foreign and responds as if it were exposed to the bug, developing an immunity.

Dr Turner says the meningococcal B vaccine works differently from others such as the measles vaccine.

Once an individual is immune to measles he or she cannot spread it to anyone else, developing what is referred to as a herd or community immunity.

The meningococcal vaccine offers an individual protection but does not appear to stop their carrying the bug and passing it on to someone else, she says. The vaccine will work in about 75 per cent of cases but not everyone's immune system will respond to it, Dr Turner says.

The vaccine, which is effective only against the epidemic group B strain, hurts and children are likely to have sore arms and legs.

* The roll-out of the meningococcal vaccine will begin in Counties Manukau and some East Auckland suburbs on July 19.

For more information about the vaccination programme, visit www.immunise.moh.govt.nz
or phone 0800 203-090.

* Do you have any questions about meningococcal disease? Email them to us at newsdesk@herald.co.nz