Meningococcal disease: information for travellers
Meningococcal infections — those caused by the bacterium Neisseria meningitidis — include meningitis (inflammation of the meninges — the lining of the brain and spinal cord), septicaemia (blood poisoning), or a combination of both.
Neisseria meningitidis can live in the external environment and, surprisingly, in the nasal passages of a proportion of the population without causing any problems.
The meningococcus bacterium is transmitted through respiratory droplets when an infected person coughs or sneezes. Meningococcal disease is one of the most serious bacterial diseases and can be fatal.
Risks for travellers
There is normally a very low risk of contracting meningococcal disease except if you are travelling in areas where epidemics are currently occurring.
Outbreaks and epidemics of meningococcal disease are commonly seen in the dry season in sub-Saharan Africa, particularly in areas extending from Senegal to Ethiopia, which has been referred to as the ‘meningitis belt’.
You should check with your doctor or a travel health centre for information about major epidemic sites. If you are travelling in identified high-risk areas, especially in the dry season, you should have a meningococcal vaccine for protection.
Meningococcal vaccination is currently not required for entry into most countries. However, proof of recent vaccination is required by Saudi Arabia for pilgrims travelling to Mecca for the annual Hajj or for the Umrah.
Of the 13 different strains (or serogroups) of meningococcus, the strains that commonly cause disease globally include strains A, B, C, W135 and Y. In Africa and Asia, the strains that most commonly cause meningococcal disease are A and W135, while in Australia the most common disease-causing strains are B and C.
Travellers should be aware that there is no single meningococcal vaccine that protects against all strains of meningococcal disease.
Quadrivalent meningococcal vaccine
Quadrivalent meningococcal vaccine offers protection against 4 strains of meningococci — A, C, W135 and Y, and is recommended if you are travelling to current meningococcal epidemic areas or staying in regions that have been known to be at risk of epidemics. Immunisation with quadrivalent vaccine is required by Saudi Arabia for pilgrims visiting Mecca for the Hajj or Umrah.
The vaccine must be administered at least 10-14 days before travelling. Booster doses may be needed after 5 years for further travel to at-risk areas.
Meningococcal C vaccine
Vaccination against group C meningococcus is recommended at 12 months of age as part of the National Immunisation Program Schedule.
Meningococcal B vaccine
There is a vaccine against group B meningococcus, however this vaccine is currently not available as part of the National Immunisation Program Schedule. This vaccine is available through purchase on the private market and can be given from the age of 2 months.
Meningococcal B vaccine is recommended for infants and young children, adolescents aged 15 to 19 years, and people with medical conditions that put them at high risk of meningococcal disease.
Fever is a common side effect associated with this vaccine, especially when used in children aged 2 to 12 months. It is recommended that paracetamol is given with meningococcal B vaccine to prevent or reduce fever.
Vaccination side effects
Possible adverse effects associated with meningococcal vaccination include:
- redness and soreness at the injection site;
- decreased appetite;
- rash; and
2. Australian Government Department of Health. National Immunisation Program Schedule (from July 2013). http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/nips-ctn (accessed Jul 2014).
3. Immunise Australia Program. Meningococcal disease (updated 4 Mar 2014). http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-meningococcal (accessed Jul 2014).
4. World Health Organization (WHO). International travel and health, 2012. Chapter 6: Vaccine-preventable diseases and vaccines. http://www.who.int/ith/ITH_chapter_6.pdf?ua=1 (accessed Jul 2014).