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Meningitis is an inflammation of the lining around the brain, and most of the time (but not always) is an infection. If you’re very young or an older person you’re particularly at risk of serious disease, which is why you’ll be offered the meningitis vaccination.
Meningitis, what is it?
Meningococcal ACWY vaccination schedules
We’re now very fortunate to have a variety of meningococcal vaccines that are safe, effective and have had a significant impact in reducing the incidence of meningococcal disease nationally.
The vaccines are categorised into different strain groups. In the UK childhood vaccination schedule, we have the following meningococcal vaccines:
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Meningococcal ACWY vaccine for the ACWY group offered at the age of 13 yrs
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Meningococcal C vaccine given at 1 year along with the HIB vaccine (haemophilus influenzae B)
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Meningococcal B vaccine (Bexero vaccine) offered as the first baby vaccines
You’ll be eligible for free meningococcal vaccines on the NHS vaccination schedule even if you are not travelling, however this will be subject to your age.
A Meningitis ACWY Vaccination is £74 per dose. If you’re travelling (except for Hajj or Umrah) then there will also be a Travel Consultation cost of £30 per person, however, if you’re not travelling then it’s only the vaccination cost you pay.
Meningitis vaccine price
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As a traveller you should take care to ensure good hygiene practices, especially your hands. Also, avoid activities which are likely to lead to the exchange of bodily fluids, such as sharing drinks or eating utensils. And where possible try to avoid spaces that are overcrowded or confined.
Prevention
This infection is often life threatening but the meningococcal vaccine has been very effective in reducing the incidence of meningococcal disease following its introduction into the UK childhood vaccination schedule. If you do develop any of the above symptoms, you’ll need urgent medical help because early treatment with intravenous antibiotics could be life saving. You’ll either be given intravenous benzylpenicillin or cefotaxime for bacterial meningitis.
Meningitis treatment
Meningococcal bacteria cause two distinct types of disease. Firstly, we’ve already mentioned it can cause meningitis which is an inflammation of the lining around your brain. However, the second type is meningococcal septicaemia ( the bacteria multiplying in your blood, causing ‘blood poisoning’) which is even more serious and is associated with a higher risk of death. With meningitis you might experience the sudden onset of the following symptoms: - Intense headache - Neck stiffness - The light hurting your eyes (photophobia) - Nausea and vomiting - Chills, confusion and dizziness - Red-purple coloured rash that does not fade when you press a glass against the skin This can progress to meningococcal septicaemia which you’ll need to recognise when it happens. You or your child will quickly develop chills, confusion, dizziness and feel extremely unwell. If you do get a rash (and not everyone does in our experience) it’s usually a red-purple colour that does not fade when you press a glass tumbler against the skin.
Meningitis symptoms
Meningitis is predominantly caused by bacteria and in particular, meningococcal bacteria. This bacteria gives you the characteristic meningococcal meningitis rash (the so-called ‘meningococcal glass test’) You can potentially be infected by six main strains of meningococcal meningitis: A, C, W, Y, B and X. Thankfully, we now have a vaccine for all the strains apart from X. Another common cause of meningitis is pneumococcal meningitis caused by Streptococcus pneumoniae. Again, this bacteria can affect the very young and old and so both groups are also offered the pneumococcal meningitis vaccine. Haemophilus influenzae, another cause of bacterial meningitis, however it is far less common because of universal childhood vaccination.
Meningitis causes
Common meningitis vaccine side effects include painful or a red injection site and fever.
Meningitis vaccine side effects
The meningitis ACWY vaccines last for about 5 years. If you’re going to the Umrah or Hajj pilgrimage then you’ll need to renew your meningitis ACWY vaccine certificate every 5 years.
Meningococcal meningitis commonly occurs in those people living and socialising in very close quarters.
You’re potentially at risk if you attend festivals, scout jamborees, or live in communal lodging, such as army barracks and boarding schools. There have also been well publicised meningococcal outbreaks during the pilgrimages to Umrah and the Hajj in Saudi Arabia.
If you’re travelling, there are some parts of the world that have regular meningococcal meningitis outbreaks. The so-called ‘meningitis belt’ of Saharan and sub-Saharan Africa is a large area where regular outbreaks occur during the dry season. The area includes the Sahara region, West Africa, East Africa and has now extended down to Zambia in the south. So, in summary if you’re travelling to areas that have regular outbreaks or areas where there is a new outbreak then you’re at risk.
You’re also risk if you belong to any of the following groups:
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Healthcare workers in countries where meningococcal meningitis is common
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Long stay travellers (especially those who will have close contact with the local population)
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People visiting friends or relatives
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Those travelling for Hajj and Umrah in Saudi Arabia
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People who will be living/travelling rough (e.g., backpackers)
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People who have no spleen or a poorly functioning spleen
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People who have certain immune deficiencies
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If you’re pregnant then your vaccination specialist should weigh up the benefits and risks of the vaccination and help you make an informed decision. There's currently no evidence that inactivated vaccines such as the men ACWY cause harm to the mother or baby.
The incubation period has a range of 2 - 10 days with an average of 4 days.
You’re most vulnerable from meningococcal meningitis when you're in close contact with carriers of the disease. When they cough, sneeze or engage in other forms of close contact, such as kissing, they can potentially infect others. So, it’s really close contact rather than casual social interactions.
Frequently asked questions
Authors:
Dr Ravi Gowda, Consultant in Infectious Diseases and Travel Medicine
MBBS, MRCP(UK), DTM&H, MRCGP, DCH, DRCOG, DFFP
Caitlin Lancaster, BSc
Resources: