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
- Joint and muscle pains
There are also more specific symptoms, such as:
- A stiff neck
- Dislike of bright lights
- 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.