Meningitis B: what are the symptoms, how is it spread and is there a vaccine? | Meningitis
Health officials have confirmed that meningitis B is the strain identified in some cases in Kent, in an outbreak that killed two young people and left 11 others in hospital.
What is meningitis B?
Meningitis is an infection of the protective lining of the brain and spinal cord. It is caused by different bacteria and viruses. Meningitis B, known as MenB, is the most common form of invasive meningococcal disease. It is caused by the Neisseria meningitidis bacteria, also known as meningococcus.
This bacteria usually lives harmlessly in people’s throats, but can cause life-threatening illnesses if it enters the blood or spinal fluid.
What are the symptoms?
MenB can progress quickly. Early symptoms are not always present, but may include sudden high fever, stiff neck, severe and worsening headache, and a rash that does not go away when a glass is pressed. They may also include aversion to bright lights, vomiting and diarrhea, seizures, joint and muscle pain, delirium, and extreme drowsiness.
Is it serious?
MenB can be fatal. Meningococcal bacteria can cause inflammation of the brain lining and sepsis, which can quickly lead to sepsis. If caught early and treated with antibiotics, most people will make a full recovery. But around one in ten infected people die from it, and it can lead to long-term complications such as hearing loss, amputation, epilepsy or learning disabilities.
How contagious is it?
MenB is spread through prolonged, close contact – usually through coughing, sneezing and kissing. Increased risk among adolescents is often associated with moving away from home and living in crowded conditions, according to Professor Paul Hunter of the Norwich School of Medicine at the University of East Anglia.
“About 10% of people carry the bacteria at any given time and this figure is even higher among adolescents,” he said. “The infection is spread between people through close contact, for example living in the same household or kissing (mouth to mouth).”
He added: “There is a lag between exposure and when people get sick, which is usually less than a week, but can be up to 10 days.
“If you had a single case, you would tend to just contact the family and give them antibiotics. If you had two cases in a class, in a school, you would give antibiotics to the whole class. If you had two cases in a school, not in the same class, you would give antibiotics to the whole school.
“When you realize you have a significant problem, it’s important to give people antibiotics. You can go from being mildly ill while walking to dying in less than a day.”
Hunter said it was not unusual to see a cluster of cases, with 300 to 400 cases of invasive meningitis typically recorded in a year. “We see clusters all the time,” he said. “What’s unusual is the size of this cluster. That’s what’s scary.”
It is unclear what exactly led to an outbreak of such magnitude. “It could be that there is a new strain that is more virulent, or because of what happened at the nightclub,” Hunter said.
Can you get MenB by sharing a vape?
If you share a vape, you transfer saliva between you. It is therefore considered a high risk of transmitting bacteria and viruses, in the same way as sharing toothbrushes or drinks, because vapes come into direct contact with the mouth. A mother of a girl hospitalized with the disease said she suspected her daughter contracted it through vaping.
Simon Williams, public health researcher and senior lecturer at Swansea University’s College of Human and Health Sciences, said: “Sharing vapes would be one way that meningitis bacteria could spread. Typically this disease is spread via respiratory droplets – this can include kissing, sharing drinks, vaping or also coughing and sneezing, and being in very close contact. Things like close contact through singing and singing Speaking could also spread it as can be found in crowded indoor environments like nightclubs – provided the infected respiratory droplets are transmitted between people. This is partly why we see cases in settings such as university halls and nightclubs.
Gayatri Amirthalingam, deputy director of immunization and vaccine-preventable diseases at the UK Health Security Agency (UKHSA), told BBC Radio 5 Live that people should not share vapes.
“Sharing anything that goes into your mouth is a potential risk factor for transmitting live bacteria in the mouth. So I definitely wouldn’t recommend sharing vapes in general from a hygiene standpoint. But also in that context, it seems pretty easy to stop doing it, although we’re not sure it’s causal in this case.”
How is it treated?
Treatment for meningitis includes antibiotics, intravenous fluids, oxygen for difficulty breathing, and in some cases steroids to prevent swelling around the brain.
Is there a vaccine?
Since 2015, the MenB vaccine has been offered to babies at eight weeks, with a second dose at 12 weeks and a booster at one year. Other routine childhood vaccines, including 6-in-1 vaccines and pneumococcal vaccine, may protect against meningitis. The MenACWY vaccine, which covers four other meningococcal groups, is offered to adolescents in grades 9 and 10 and can be administered up to the age of 25.. But adolescents born before 2015 are not vaccinated against MenB.
Why haven’t teenagers been vaccinated?
The Joint Committee on Vaccines and Immunization recommends which vaccines should be given to which people, based on the latest research on prevalence, vaccine effectiveness and cost-effectiveness.
Although MenB accounts for 80% of cases of invasive meningococcal disease, so far the JCVI has not judged the MenB vaccination to be cost-effective for adolescents, as it does not stop the bacteria from spreading from person to person, it does not target all the different strains of B bacteria, nor does it provide protection for particularly long.
Meningitis Now says young people should be vaccinated against meningitis B under the NHS, with those most at risk vaccinated first, followed by a booster program for adolescents from 2030. Private vaccines should also be made more affordable, it claims. Private meningitis B vaccinations cost between £100 and £120 per dose in the UK, with a full two-dose course costing between £200 and £240. Boots offers two doses for £220.
Should teenagers living near the Kent outbreak be vaccinated?
Some experts say catch-up vaccines could help reduce the risk of new outbreaks. Professor Emma Wall, Head of the Clinical Research Group at the Francis Crick Institute and Clinical Professor of Infectious Diseases at the Blizard Institute, QMUL, said: “Vaccination can be a very useful tool to reduce onward transmission of this bacteria and reduce the risk of secondary outbreaks in students or associated communities. Protection from the vaccine is rapid.”
What should you do if you think you may have been exposed to MenB?
The UKHSA says anyone suffering from symptoms of meningitis and sepsis should seek urgent medical attention at their nearest A&E department or by calling 999. Those who attended Club Chemistry in Canterbury between March 5 and 7 should present for antibiotic treatment.
