Increase in meningococcal disease in Ireland
There has been an increase in meningococcal meningitis/septicaemia in Ireland in the last two weeks with 11 cases notified since week 52 2018. Unfortunately three patients diagnosed with meningococcal disease have died, all three of these deaths were directly due to this infection.
Although the number of meningococcal disease cases generally increases in the winter months the recent increase is cause for concern. The HSE has alerted the public to the signs and symptoms of this disease, telling people to seek immediate medical attention if someone has symptoms that could be caused by this bug.
Since week 52 of 2018 a total of 11 cases of meningococcal disease have been reported to HPSC - in week 52 2018 (3 cases), in week 1 of 2019 (8 cases), no cases have been reported this week to date. This compares to 5 cases for the same time period last year. In 2018, a total of 89 meningococcal cases were notified compared to 76 in 2017.
The recent cases have occurred in Dublin and other regions of the country.
Provisional data on the strain types identified since week 52 2018 indicates that different strains of the organism are circulating and causing disease. All age groups have been affected, ranging from infants to elderly. Of the three patients who died, two of these cases had different strain types identified. Serogroup result is awaited on one case.
Following investigation none of the patients with meningococcal disease have been identified as having had contact or links with each other. They live in different areas of the city and country.
Spread of meningococcal from person to person is very unusual, especially outside of close household contact.
Meningitis is a serious illness involving inflammation of the membranes covering the brain and spinal cord. It can be caused by a variety of different germs, mainly bacterial and viruses. Bacterial meningitis is less common but usually more serious than viral meningitis and requires urgent treatment with antibiotics. Bacterial meningitis may be accompanied by septicaemia (blood poisoning). The bacteria live naturally in the nose and throat of normal healthy persons without causing illness. The spread of the bacteria is caused by droplets from the nose and mouth. The illness occurs most frequently in young children and adolescents, usually as isolated cases. Bacterial meningitis or septicaemia requires urgent antibiotic treatment.
Signs and symptoms may include:
- Fever (sometimes with cold hands and feet)
- Joint or muscle pain
- Rapid breathing
- Severe headaches
- Drowsiness
- Discomfort from bright light
- Neck stiffness
- Vomiting, stomach cramps and diarrhoea
- Non-blanching rash may appear which may be tiny red pin pricks that may develop to purple bruises. This rash does not fade under pressure.
The HSE advises that if anyone has any concerns they should contact their GP in the first instance but make sure that they seek medical attention.
Parents of children should make sure that they have received all their vaccines on time. A vaccine that protects against meningococcal C disease (MenC vaccine) is given at 6 months and at 13 months, a meningococcal B vaccine (MenB vaccine) is given at 2,4, and 12 months of age. In addition adolescents are routinely offered the MenC vaccine in the first year of secondary school. Older teenagers and young adults up to the age of 23 years who never received a MenC vaccine are recommended the MenC vaccine.
Other vaccines that protect against other forms of meningitis and septicaemia are included in the routine child vaccination programme (Hib vaccine and pneumococcal vaccine (PCV)). All children should get their vaccines in accordance with the national schedule. Children who have missed vaccines can obtain these vaccines from their GPs.
Of note, a sub-optimal uptake of meningococcal vaccines among children has been noted in recent years.
In Q2 2018, the uptake of MenC (first dose) for babies at 12 months was 90% in Q2 2018; the uptake for two doses of MenB at 12 months was 93% and the uptake of MenC at 24 months was 88%.
Among adolescents (1st year in secondary school) the uptake of MenC vaccine during the 2016-2017 academic year was 83.9%.
Further information
Meningococcal disease factsheet (HSE-HPSC)