Meningococcal Infection in Children

What is meningococcal infection in children?

Meningococcal infection is an illness caused by bacteria. The most common forms of infection are:

• Meningitis. This is infection of the membranes that surround the brain and spinal cord.

• Meningococcemia. This is infection of the bloodstream.

Meningococcal infection is not common, but it can be fatal. It occurs most often in late winter and early spring. Children are more often affected, but the illness also occurs in teens and young adults, with fewer cases in adults over age 23. People living in crowded group settings such as school dorms or military barracks are also at risk. There are 2 meningitis vaccines that can help prevent infection.

A case of meningococcal disease needs to be reported to the local public health department. This is because the infection is contagious. Staff will provide education to you and your family, as well as to the public.

What causes meningococcal infection in a child?

The infection is caused by bacteria called Neisseria meningitidis. The bacteria are spread through close contact with an infected person. A person can inhale droplets in the air from a sneeze or by talking closely with another person. This may cause infection. Most people who get the bacteria and carry them in their nose and throat never get symptoms. In rare cases, the bacteria get into the body and spread, causing serious illness.

Which children are at risk for meningococcal infection?

Children and teens/young adults are more at risk for a meningococcal infection if they have not had a meningococcal vaccine, and have been in contact with an infected person. Other risk factors include:

• Low birth weight

• Complement deficiency, a disorder of the immune system

• HIV

• Intimate kissing with multiple partners

What are the symptoms of meningococcal infection in a child?

The most common symptoms of meningitis in children, teens, and young adults older than 1 year include:

• Fever

• Neck or back pain

• Headache

• Nausea and vomiting

• Neck stiffness

• A purple-red, splotchy rash or skin discoloration

In babies, symptoms are not as easy to notice. They may include:

• Irritability

• Listlessness

• Sleeping all the time

• Refusing a bottle

• Crying when picked up or being held

• Can't be comforted while crying

• Bulging soft spot (fontanelle)

• Behavior changes

• Fever

Meningococcemia is a life-threatening illness. Symptoms may occur suddenly and get worse quickly. Treatment is needed right away. The most common symptoms include:

• Fever

• Chills

• Sore throat

• Headache, especially when flexing the neck by moving the chin toward the chest

• Sensitivity to light

• Aching muscles and joints

• Not feeling well (malaise)

• Exhaustion

• Feeling tired (lethargy)

• Rash that may be small, red, flat, or raised spots that turn into larger red or purple patches that may look like bruises

As the illness gets worse quickly, symptoms may include:

• Low blood pressure

• Very small amount of urine

• Bleeding

The symptoms of meningococcal infection can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.

How is meningococcal infection diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. Your child will have a physical exam. Your child may also have tests, such as:

• Spinal tap (lumbar puncture). A needle is placed into the lower back. It goes into the spinal canal. This is the area around the spinal cord. The healthcare provider removes a small amount of cerebrospinal fluid (CSF) and sends it for testing. CSF is the fluid that bathes your child's brain and spinal cord. The fluid is checked for bacteria.

• Blood tests. Blood may be checked for the bacteria. Other blood tests may be done to look for other signs of infection.

How is meningococcal infection treated in a child?

Treatment is needed right away. Your child will need to be in a hospital for treatment. Antibiotics are given through an IV (intravenous) line. If a child has severe allergies to penicillin, other antibiotics may be used to treat the infection. Antibiotic therapy is done for 5 to 7 days. A child in the hospital will be isolated for 24 hours after antibiotics have been started.

Other treatments are aimed at treating the symptoms. A child with a severe infection may need extra (supplemental) oxygen. They may be put on a ventilator to help with breathing.

What are possible complications of meningococcal infection in a child?

Meningitis can lead to coma and death, or can result in deafness. Meningococcemia can lead to shock. This is a life-threatening condition. It causes very low blood pressure. Not enough blood flows to organs such as the kidneys, liver, and brain. Some children will have a lack of blood flow to the fingers, toes, and other parts of their limbs. This causes a deadening of these tissues (gangrene). That might lead to amputation.

How can I help prevent meningococcal infection in my child?

There are 2 types of meningococcal vaccines:

• MenACWY. The CDC advises that all children 11 to 18 years old have the meningococcal conjugate vaccine (MenACWY). MenACWY is given to children between 11 and 12 years of age, with a booster at age 16. If the vaccine was not given at age 11 to 12, it should be given when starting high school, with a booster dose a few years later. Certain high-risk babies and young children may also be advised to get the vaccine.

• MenB. This vaccine protects against serotype B. This is an increasingly common strain that can cause meningococcal meningitis. The CDC recommends that certain adolescents and young adults ages 16 through 23 years receive a MenB vaccine. This includes those at risk for serogroup B meningococcal disease outbreak (such as military recruits and college students living in close quarters). That also includes people with certain high-risk medical conditions. Some children 10 years or older with high-risk medical conditions may be advised to get the MenB vaccine. Talk with your child's healthcare provider to learn more.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has any symptoms of meningococcal infection. If your child appears seriously ill or is getting ill quickly, get medical help right away.

Report cases of meningococcal disease to your local public health department. Staff will provide education to you and your family, as well as to the public.

Key points about meningococcal infection in children

• Meningococcal infection is an illness caused by bacteria. The most common forms of infection are meningitis and meningococcemia. Meningitis is infection of the membranes that surround the brain and spinal cord. Meningococcemia is infection of the bloodstream.

• Meningococcal infection is not common. It can be fatal.

• Children, teens, and young adults are most often affected. People living in crowded group settings such as school dorms or military barracks are also at risk.

• The most common symptoms of meningitis can include fever, neck or back pain, headache, neck stiffness, nausea and vomiting, and a rash.

• Treatment is needed right away. Your child will need to be in a hospital for treatment.

• The CDC advises that all children 11 to 12 years old should get a MenACWY vaccine, with a booster dose at 16 years old. Certain teens and young adults ages 16 through 23 years may get a MenB vaccine depending on risk. One or both types of meningococcal vaccines may be advised for some children depending on risk. Talk with your child's healthcare provider.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours, and on weekends and holidays. This is important if your child becomes ill and you have questions or need advice.