Meningococcal disease

When you are assessing patients with influenza symptoms, be alert for meningococcal disease. Meningococcal disease, like influenza, is more frequent during the cold season. Infection with Neisseria meningitidis results in a wide range of presentations, but most commonly meningitis and/or septicaemia. Approximately two-thirds of cases have a rash, which may be petechial, purpuric or, less commonly, maculopapular and urticarial.

NEISVAC-C® and/or MENACTRA® are recommended and funded for individuals post-haematopoietic stem cell transplantation, pre- or post-solid organ transplantation; pre- or post-splenectomy; or with functional asplenia, or complement deficiency (acquired or inherited); or who are immunosuppressed due to steroid or other therapy for longer than 28 days; HIV-positive; or a close contact of a meningococcal disease case.

For further information on meningococcal disease and vaccines please refer to Chapter 12 in the on-line (or electronic) Immunisation Handbook 2014 or www.health.govt.nz/our-work/diseases-and-conditions/meningococcal.

Symptoms of meningococcal disease

Be alert for patients who may present with flu-like symptoms.

Meningococcal disease usually has a sudden onset with:

  • A high fever
  • Headache
  • Sleepiness
  • Joint and muscle pains

There are also more specific symptoms, such as:

  • A stiff neck
  • Dislike of bright lights
  • Vomiting
  • Crying
  • Refusal to feed (in infants)
  • A rash consisting of reddish-purple pin-prick spots or bruises*

* The presence of a petechial or purpuric (non-blanching) rash must be taken very seriously

Those particularly at risk of meningococcal disease are children aged less than 5 years, although all age groups may be infected and there is a higher case fatality rate in adults. The presentation may be nonspecific in young infants.

For the NEISVAC-C®, MENACTRA®, and NIMENRIX® Datasheets please refer to the Medsafe website www.medsafe.govt.nz.