Meningitis and Vaccine

Meningococcal meningitis is an acute bacterial disease characterized by sudden onset of fever, intense headaches, nausea (often vomiting), stiff neck, and frequently a rash will occur.  It is usually spread by direct contact with an infected person, especially from respiratory droplets from the nose and throat, and is most common during winter and spring.  Many carriers do not develop the illness, but they may transmit the disease for about 6 months.  The incubation period may vary from 1-10 days.  Untreated, meningococcal meningitis is almost always fatal.

Meningococcal Vaccine

Meningococcal vaccine is an inactivated-bacteria vaccine, given subcutaneously, that provides active immunity against meningococcal meningitis.  There are many serogroups of meningitis, with the current vaccine being effective against A, C, Y, & W135 and having an estimated efficacy of 85-90%.  A booster may be recommended every 3-5 years.  Vaccination against meningococcal meningitis is not a requirement for entry into any country, but it is required for pilgrims to Mecca, Saudia Arabia for the annual Haj or Umra. Vaccine is indicated for travelers to countries recognized as having epidemic meningococcal disease.  In subSaharan Africa epidemics of meningococcal disease occur frequently during the dry season (December through June).  Meningococcal disease in Americans traveling in such areas is rare.  However, because of the lack of established surveillance and timely reporting from many of these countries, travelers to this region during the dry season should receive meningococcal vaccine, especially if prolonged contact with the local populace is likely.  The vaccine should be given 1-2 weeks before departure to allow maximum antibody response.

Possible Side Effects

Adverse reactions to meningococcal vaccine are infrequent and mild.  Local tenderness and redness that last 1-2 days, headache, malaise and fever may occur.

Contraindications

• Anaphylactic reaction to a previous dose
• Moderate illness, with or without fever
• Allergy to thimerosal (a preservative found in some vaccines and some contact lens solutions)

Precautions

• Pregnancy
• If the vaccine is used in persons receiving immunosuppressive therapy, the expected immune response may not be obtained.

Questions or side effect reporting: 
Call Olin Health Center, Travel Clinic at 353-3161.

Sources: Control of Communicable Disease in Man, 1995.
  CDC Health Information for International Travel, 1997.
  Travel and Routine Immunizations, 1999.
  International Travel Health Guide, 1997.
  Connaught-Menomune Vaccine Insert, July 1990.