Meningococci: Vaccination, infection & symptoms

Quick overview: Frequently asked questions and answers

What happens if you have meningococci? The bacteria cause a serious infection. The condition can worsen quickly and complications such as meningitis or blood poisoning are possible.

How do you recognize the disease? Early symptoms are similar to flu, with fever, malaise and headache. Also typical are stiff neck and sensitivity to light.

Where do you get meningococci? Transmission occurs via droplet infection through coughing, sneezing or close contact.

How useful is vaccination? The STIKO vaccination commission recommends vaccination against serotypes B and C for children. The protection does not last for life, but booster vaccinations are necessary.

Article overview:

What are meningococci?

Meningococci (Neisseria meningitidis) are bacteria that occur worldwide. They can settle in the mouth and nose of humans and lead to a serious, sometimes even life-threatening illness. Most often, purulent meningitis develops, and sepsis (blood poisoning) is also possible.

There are twelve different meningococcal serogroups (A, B, C, E, H, I, K, L, W, X, Y, Z). The distinction is made based on the structure of the capsule that surrounds the bacteria.

Meningococci: Vaccination for prevention

There are vaccines against the various meningococcal serogroups. Since 2006, the STIKO (Standing Committee on Vaccination) has recommended that all children aged 12 months be vaccinated against meningococcal serogroup C. If this is missed, adolescents up to the age of 18 should be given a catch-up vaccination.

Since January 2024, the STIKO has also recommended that all infants aged two months and older be vaccinated against meningococcus B (MenB). This should be done by the age of five. The costs are now covered by statutory health insurance companies as part of their mandatory benefits.

Vaccination for certain risk groups

Risk groups that are particularly at risk for meningococcal infection should also be protected with a meningococcal ACWY conjugate vaccine. In a conjugate vaccine, the bacterial antigens are coupled to a protein carrier molecule to enhance the effect.

The vaccine provides protection against the four serogroups. A vaccine against serotype B should also be administered.

The groups of people at risk include:

• People with congenital or acquired immune deficiencies

• Laboratory personnel who are particularly at risk of becoming infected with meningococci due to their work

• Contacts of a person infected with meningococcus

• People who travel to epidemic countries and have contact with local people there. For example, development workers or medical personnel.

There is also a vaccination recommendation for people if meningococci occur in a particular region. In special cases, the local health authority will call for this.

Symptoms of meningococcal disease

For many people, a meningococcal infection causes a strong feeling of illness. Common symptoms are:

After just a few hours, the condition can become life-threatening. Large skin hemorrhages (petechiae) can occur, among other things. If the condition progresses to septicemia, a drop in blood pressure and organ failure are possible consequences.

In infants and young children, the symptoms of meningococcal infection often look different. In addition to fever and vomiting, drowsiness and cramps can also occur. A hardened fontanelle (the gap between the skull plates in infants) is also possible.

Infection with meningococci

Outside the body, the bacteria die relatively quickly. Meningococci are usually transmitted through droplet infection. When speaking, coughing or sneezing, they are released into the air through small droplets and, if there is close contact, into the nasopharynx of the person opposite. If the secretion is touched and then comes into contact with your own face, infection can also occur.

The incubation period, i.e. the time until the disease breaks out, is approximately three to four days. However, a period of between two and ten days is also possible.

Meningococci: How long is it contagious?

Infected people can be contagious as early as seven days before symptoms appear. Once antibiotic treatment has begun, there is no longer any risk of infection after about 24 hours.

Consequences of a meningococcal infection

In most cases, meningococcal disease leads to meningitis (inflammation of the meninges). In Germany, over two thirds of cases result in sepsis. Of these, 10 to 15 percent develop a severe form of septic shock, Waterhouse-Friderichsen syndrome. This is characterized by bleeding into the adrenal glands and is very often fatal.

Invasive meningococcal infection can rarely lead to the following diseases:

Diagnosis if meningococci are suspected

If people suffer from the typical symptoms, they should go to a hospital immediately. To make an accurate diagnosis, doctors take blood and cerebrospinal fluid, which are then examined in the laboratory for the presence of pathogens.

A throat swab is useful if treatment has already begun but the exact pathogen needs to be identified.

Treatment of meningococcal disease

As soon as an invasive infection with meningococci is detected, treatment with antibiotics begins immediately. Group three cephalosporins are recommended, provided the patient is not allergic to penicillin.

Depending on how the symptoms manifest, further treatment measures are necessary. In the case of sepsis, observation and further treatment in the intensive care unit is always required.

Close contacts (especially household contacts) receive chemoprophylaxis with antibiotics. In addition, a vaccination against meningococci should be given if possible. Studies show that these people have an increased risk of becoming infected with the bacteria in the following year despite antibiotic therapy.