Sports injuries

January/February 2010

Meningococcal meningitis

Prevention in travellers

Volume 39, No.1, January/February 2010 Pages 35-38

Cora A Mayer

Amy A Neilson

This article is the first in a series providing a summary of prevention strategies and vaccination for infections that may be acquired by travellers. The series aims to provide practical strategies to assist general practitioners in giving travel advice, as a synthesis of multiple information sources which must otherwise be consulted. The risk of travel associated meningococcal disease is generally small for travellers, and epidemics are difficult to predict. However, it is a potentially very serious infection with high mortality. Vaccination is recommended for travellers to high risk or endemic areas, particularly arid sub-Saharan regions and areas with current or recent epidemics. Internet based resources are available for up-to-date outbreak information.

Infections caused by Neisseria meningitidis, a Gram-ve diplococcus, can cause severe febrile illness associated with meningitis, sepsis or a combination of both, with a high risk of mortality (approximately 10% in Australia with appropriate antibiotic treatment). Uncommonly, pneumonia, arthritis and other localised infections can occur.1 Spread is via respiratory droplets, with an incubation period of 1–14 days.2 Often infection does not cause clinical disease,3 and 5–25% of the population are asymptomatic respiratory tract carriers,1,4,5 with greater prevalence in those who smoke or live in crowded conditions.1 Invasive disease occurs at a background rate of 0.5–10.0 cases per 100 000 population/year, and up to 1000 per 100 000 population/year in epidemic areas.5,6

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