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What causes invasive meningococcal disease (IMD)?

Meningococcal disease is rare, but is easily misdiagnosed, unpredictable, and potentially deadly.[1], [2]

The disease can progress from initial nonspecific symptoms, such as fever and irritability, to death in as few as 24 hours.[2-4]

Bexsero Disease Burden

Who is at risk? and is there a higher risk of infection at different ages?

MenB can strike at any age, but is most frequent in infants and children less than 5 years of age.[6]

Bexsero Disease Burden

*Contributing countries: Austria, Belgium, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary,Ireland, Italy, Latvia, Lithuania, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden,and the United Kingdom

In Europe, MenB incidence is highest in infants, and children less than 5 years of age[6]

18% of MenB cases in EU occur in adolescents (15-24 years of age)[6]

In Ireland, in the first half of 2018, 59 cases of invasive meningococcal disease (IMD), were notified:

  • 52.5% of these were serotype B.[6], [7]

The number of IMD cases reported in Q2-2017 (n=20) was greater than the average number reported in the same quarter over the previous three years (average=18.7 95%CI 16.2-21.1); for serogroup B, the average was 12.3 and for serogroup C it was 3.0[3]

A serious threat with serious consequences[1], [4], [8]

The consequences of meningococcal disease can be devastating[1], [4], [8]

Permanent consequences in survivors can include but are not limited to neurological disability, limb and digit amputations, hearing loss and seizures[1], [4], [8]

What are the symptoms of invasive meningococcal disease (IMD)?

Because early symptoms of meningococcal disease are difficult to distinguish from those of more common but less serious illnesses, appropriate and potentially life-saving treatment options may be delayed[1], [3], [10]

The early signs and symptoms of IMD including fever, irritability, cold-like symptoms, headache, loss of appetite, nausea and vomiting, resemble those of common viral illnesses[3], [9], [10]

The lack of distinct IMD-specific early symptoms often results in initial misdiagnosis[3]

Intervention often does not occur until identification of later symptoms that are IMD-specific, such as haemorrhagic rash (i.e., rash associated with bleeding under the skin surface) or neck stiffness[3]

What options can help to prevent meningococcal disease?

Keeping up to date with recommended immunisation is the best defence against meningococcal disease. Maintaining healthy habits like getting plenty of rest and not coming into close contact with people who are sick can also help.[11]

References:

  1. Rosenstein NE, Perkins BA, Stephens DS, et al. Meningococcal disease. N Engl J Med. 2001;344(18):1378–1388.
  2. Pelton, SI. Meningococcal disease awareness: clinical and epidemiological factors affecting prevention and management in adolescents. J Adolesc Health. 2010;46:S9-S15.
  3. Thompson MJ, Ninis N, Perera R, et al. Clinical recognition of meningococcal disease in children and adolescents. Lancet. 2006;367(9508):397–403.
  4. World Health Organization (WHO). Meningococcal Meningitis Fact Sheet. www.who.int/mediacentre/factsheets/fs141/en. Updated November 2015. Last accessed November 2018.
  5. ECDC. Surveillance of invasive bacterial diseases in Europe. Invasive pneumococcal disease, invasive Haemophilus influenza disease and invasive meningococcal disease, 2012. Available at: http://ecdc.europa.eu/en/publications/_layouts/forms/Publication_DispForm. aspx?List=4f55ad51-4aed-4d32-b960-af70113dbb90&ID=1261. Accessed November 2018.
  6. HPSC. Invasive Meningococcal Disease (IMD), Other Bacterial Meningitis, Haemophilus Influenzae & Viral Meningitis Infections in Ireland. 2018 (Q1 Report). Available from:http://www.hpsc.ie/a-z/vaccinepreventable/bacterialmeningitis/publications/quarterlyreports/2018reports/IMD%20Bacterial%20%20Viral%20Meningitis%20%20Haemophilus%20Rpt-Q1-2018%20v.1.2.pdf, accessed: November 2018.
  7. HPSC. Invasive Meningococcal Disease (IMD), Other Bacterial Meningitis, Haemophilus Influenzae & Viral Meningitis Infections in Ireland. 2018 (Q2 Report). Available from: http://www.hpsc.ie/a-z/vaccinepreventable/bacterialmeningitis/publications/quarterlyreports/2018reports/IMD%20Bacterial%20%20Viral%20Meningitis%20%20Haemophilus%20Rpt-Q2-2018%20v.1.0.pdf, accessed: November 2018.
  8. Viner RM, Booy R, Johnson H, et al. Outcomes of invasive meningococcal serogroup B disease in children and adolescents (MOSAIC): a case-control study. Lancet Neurol. 2012;11(9):774-783.
  9. CDC. Manual for the surveillance of vaccine-preventable diseases. Available from: http://www.cdc.gov/vaccines/pubs/surv-manual/index.html Last accessed November 2018.
  10. Jafri et al. Population Health Metrics, Global epidemiology of invasive meningococcal mdisease; 2013; 11–17.
  11. CDC webpage: Meningococcal Home/About the Disease. Available from: http://www.cdc.gov/meningococcal/about/prevention.html Last accessed November 2018

Adverse events should be reported to the Health Products Regulatory Authority (HPRA) using an Adverse Reaction Report Form obtained either from the HPRA or electronically via the website at www.hpra.ie. Adverse reactions can also be reported to the HPRA by calling: (01) 6764971. Adverse events should also be reported to GlaxoSmithKline on 1800 244 255.

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