Meningococcal Infections in Children

What are meningococcal infections in children?

Meningococcal infections are illnesses caused by bacteria. The most common forms of infections are:

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

• Meningococcemia. This is infection of the bloodstream.

Meningococcal infections are not common, but they can be fatal. They occur most often in late winter and early spring. Children are more often affected, but the illnesses also occur in teens and adults. 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. Staff will provide education to you and your family, as well as to the public.

What causes meningococcal infections in a child?

The infections are caused by bacteria called Neisseria meningitidis. The bacteria are spread through close contact with an infected person. A child can inhale droplets in the air from a sneeze or by talking closely with another child. 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 grow fast, causing serious illness.

Which children at risk for meningococcal infections?

Children 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 infections in a child?

The most common symptoms of meningitis in children 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. The rash 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 infections can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.

How are meningococcal infections 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, 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 are meningococcal infections 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. 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 severe infection may need extra (supplemental) oxygen or be put on a ventilator to help with breathing.

What are possible complications of meningococcal infections in a child?

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.

How can I help prevent meningococcal infections 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). The 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 the most common strain known to cause meningococcal meningitis. 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) and 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.

If exposed

Anyone who has been in close contact with an infected child may also need antibiotics. If you have questions, talk with your child's healthcare provider. The CDC advises the following people be treated if exposed to the bacteria:

• Other members of the household, especially young children

• Adults and children at child care or nursery school

• Anyone who has had contact with the infected child's body fluids through kissing or sharing a toothbrush, cups, or eating utensils

• People who sleep in the same area as the infected child

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 infections in children

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

• Meningococcal infections are not common, but they can be fatal.

• Children are more often affected, but the illnesses also occur in teens. 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 18 years old get the MenACWY vaccine. 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. This is important if your child becomes ill and you have questions or need advice.