Meningococcal meningitis

On this page you’ll find an overview of meningitis caused by meningococcal bacteria, including symptoms, treatment and prevention.

• It’s estimated that, on average, every two minutes somebody in the world will get meningococcal meningitis.¹
• In general, children under the age of five and teenagers are at the highest risk of developing meningococcal meningitis.
• Serious illness caused by meningococcal bacteria is called invasive meningococcal disease.  This disease can cause meningitis, sepsis or both together. 
• There are vaccines available that offer protection against meningococcal meningitis.

What is meningococcal meningitis?

Meningococcal meningitis is the swelling of the membranes, called meninges, that cover and protect the brain and spinal cord. It’s caused by meningococcal bacteria, sometimes known as meningococcus (singular), meningococci (plural) or by the scientific name Neisseria meningitidis. Meningococcal bacteria are a leading cause of bacterial meningitis globally.

When these bacteria cause severe disease, they typically spread through the body in one of two ways. They can infect the bloodstream (causing sepsis), or infect the fluid surrounding the brain and spinal cord (causing meningitis). Many patients develop both conditions at the same time. These severe infections are known collectively as invasive meningococcal disease.

What are the symptoms of meningococcal disease?

Many patients with meningococcal meningitis will also have symptoms of sepsis. Patients with pure sepsis have the worst outcomes, so knowing the symptoms is vital.

Not everyone gets all the symptoms and they can appear in any order, but sepsis symptoms often appear earlier. 

Symptoms may include: 

Symptoms in babies and very young children can be slightly different. Their symptoms may include: 

• High temperature (warning: could be normal or low in babies under three months old).
• Irritability.
• Vomiting / refusing to feed.
• A high-pitched cry.
• A stiff body with jerky movements or else floppy and lifeless.
• Very sleepy / staring expression / too sleepy to wake up.
• Tense or bulging soft spot on the top of their head.

Not everyone with meningococcal disease will get all these symptoms. 

People with meningococcal disease will get worse fast. Check regularly on someone who is unwell. Always trust your instincts and get medical help straight away if you or someone you know is seriously ill. 

Read more information about the symptoms of meningitis and sepsis.

How do you get meningococcal disease?

Meningococcal disease is contagious, but most cases are isolated with no links to any other cases. 

Meningococcal bacteria live harmlessly in the back of the nose and throat of about one in ten people.² They pass from person to person through coughing, sneezing and close physical contact like kissing. Only a small fraction of people who are exposed to meningococcal bacteria become ill with meningococcal disease. 

We don’t fully understand why the bacteria cause such severe disease in some people while others carry them harmlessly. It’s most likely a combination of factors, including:

• Whether the person has any immunity to the bacteria.
• Whether they have any other health conditions or infections.
• The genetics of both the person and the bacteria.

Who can get meningococcal disease?

Meningococcal meningitis and invasive meningococcal disease can affect anyone, but children under the age of five and teenagers are at the highest risk.

Your risk of getting the disease is also affected by where you live. Meningococcal meningitis is much more common in a region of Sub-Saharan Africa known as the African Meningitis Belt.
Certain environmental factors and behaviours also increase your risk of disease, such as living in crowded conditions and active and passive smoking.

Some mass gathering events have also been associated with outbreaks of meningococcal disease such as the Hajj. Pilgrims going on Hajj must be vaccinated before they travel to Saudi Arabia.

Your risk also increases if you have certain health conditions such as:

• If you don't have a spleen, or your spleen doesn’t function properly.
• Complement disorders. These are genetic differences affecting a vital part of your immune system (the complement system). They make it harder for your body to recognise and destroy meningococcal bacteria.
• Immunosuppression (due to diseases like HIV or treatments like chemotherapy).

How is meningococcal disease treated?

Meningococcal disease can lead to meningitis or sepsis, and must always be treated urgently with antibiotics. 

The disease can kill quickly, so if you suspect you have it, you should seek immediate medical care. Prompt recognition and hospital treatment offer the best chance of a good recovery.

When you get to hospital, the doctor may take blood tests and do a lumbar puncture (LP) to help diagnose meningitis. A lumbar puncture involves taking a sample of cerebrospinal fluid from the spinal canal (the passageway through the back bones which contains the spinal cord). A lumbar puncture is important to confirm the diagnosis of meningitis. It will also show which germ is causing the illness so doctors can choose the most appropriate treatment.

You may be given antibiotics intravenously (directly into the vein).

If you’re very unwell, you might be transferred to a special ward in the hospital where you can be regularly monitored by hospital staff. In the UK this is known as an Intensive Care Unit.

What are the after-effects of meningococcal disease?

Meningococcal disease affects everyone differently. Most people make a full recovery without any lasting problems. But in some cases, it can cause ongoing problems which may need further treatment and support. 

The possible after-effects of meningitis include:

• Learning and intellectual disabilities such as memory loss, lack of concentration or issues with thinking and problem solving.
• Clumsiness and co-ordination problems.
• Headaches.
• Deafness, hearing problems, tinnitus, dizziness or loss of balance.
• Epilepsy or seizures.
• Weakness, paralysis or spasms.
• Speech problems.
• Loss of sight or vision problems.
• Hydrocephalus (fluid on the brain).
• Mental health issues and changes to personality or behaviour.
• Difficulties with sleep.
• Fatigue.
• Anxiety and depression.

• Arthritis or joint stiffness.
• Scarring or skin damage.
• Damage to bones and joints.
• Loss of fingers, toes and limbs (amputations).
• Kidney damage.

Is there any follow-up care after recovery from meningococcal disease?

Ideally, you should be given information about what to expect during recovery before you leave the hospital. The follow-up care you receive will be different depending on where you are in the world, and the guidelines that your local doctors follow. You may have further treatment involving different teams of doctors and specialists.

In some countries (including the UK), doctors will arrange at least one follow-up appointment so they can check for longer term after-effects. This is particularly important for children, as some long-term neurodevelopmental complications can't always be identified immediately after their illness.

Read more about the follow-up care after recovery from meningitis

Can we prevent meningococcal disease?

Yes, certain types (or serogroups) of meningococcal disease can be prevented.

Meningococcal bacteria are surrounded by a sugar capsule. It’s the presence and structure of this capsule which defines the serogroup that the bacteria belong to. A total of twelve differently structured capsules have been identified, six of which cause invasive meningococcal disease (serogroups A, B, C, W, X, Y).

There are several types of meningococcal vaccines available that protect against different combinations of these serogroups:

• Polysaccharide vaccines. These provide protection for a relatively short space of time, but unfortunately they don’t work for children. Polysaccharide vaccines available include MenACWY.
• Conjugate vaccines. These produce a robust immune response in children and stop those who are immunised from carrying the bacteria and passing it to others. Conjugate vaccines available include the MenACWY vaccines, the MenA vaccine, and the MenACWYX vaccine.
• Protein and outer membrane vesicle (OMV) vaccines. These have been developed specifically to protect against MenB bacteria.

Not all meningococcal disease is vaccine-preventable, so being aware of the symptoms of the disease remains important.

Can I get a vaccine to protect me against meningococcal disease?

The risk of getting meningococcal disease changes according to where you live, and specific types of meningococcal bacteria are more common in different regions of the world. So the vaccines that are available and recommended will depend on where you live.

There is no recommendation from the World Health Organisation (WHO) for meningococcal vaccines globally. The Ministry of Health in your country will decide whether to provide a routine meningococcal vaccination programme, using local data about the cases, deaths and impact of the disease. Many countries don’t have a routine immunisation programme for meningococcal disease.

People who live in an area of sub-Saharan Africa known as the Meningitis Belt are at the highest risk of getting meningococcal meningitis compared to anywhere else in the world. The WHO recommends that all countries within the African Meningitis Belt introduce routine vaccination with MenACWYX in children aged nine to eighteen months.⁴ The vaccine is not yet routinely available in all countries within the Meningitis Belt.

Taking up all the vaccines available to you is the best way to protect you and your family.

Our Meningitis Progress Tracker provides information about whether meningococcal vaccines are available in your country and what types they are. Alternatively, you can find out about your own country’s immunisation programme on the WHO Immunization Data Portal.

Vaccination in the UK and Ireland

• Men ACWY, offered to teenagers aged thirteen to fifteen.
• Men B, offered to babies at eight and sixteen weeks with a booster aged one.
• Men C, offered to children aged twelve to thirteen months (as a combined MenC/Hib vaccine) with a booster dose (with the MenC containing vaccine, Men ACWY) for teenagers at fourteen.