12 Meningococcal disease

Key information

Mode of transmission By respiratory droplets or direct contact with nasopharyngeal secretions from a carrier or case.
Incubation period 2–10 days, commonly 3–4 days.
Period of communicability Therapy with rifampicin, ceftriaxone or ciprofloxacin eradicates N. meningitidis from mucosal surfaces within 24 hours, and the case is no longer considered infectious.
Suspected cases Administer antibiotics as soon as possible (prior to transport to hospital).

Notify all suspected cases as soon as possible.
Available vaccines Meningococcal group C conjugate (MenCCV): NeisVac-C.

Quadrivalent meningococcal conjugate (MCV4): Menactra (MCV4-D) – conjugated to diphtheria toxoid; Nimenrix (MCV4-T) – conjugated to tetanus toxoid.

Quadrivalent meningococcal polysaccharide (4vMenPV): Mencevax ACWY.
Funded vaccine indications MCV4-D (Menactra) or MenCCV (NeisVac-C) for :
  • patients pre- or post-splenectomy or with functional asplenia
  • patients with HIV, complement deficiency (acquired, including monoclonal antibody therapy against C5, or inherited) or pre- or post-solid organ transplant
  • bone marrow transplant patients
  • patients following immunosuppression
  • close contacts of meningococcal cases (of relevant serotype).
Vaccine efficacy/effectiveness Meningococcal conjugate vaccines are preferred over polysaccharide vaccines because they allow vaccination in younger children and are associated with the development of herd immunity.
Precaution Individuals with a history of Guillain-Barré syndrome who are considering immunisation with MCV4-D.
Management of close contacts Antibiotic prophylaxis – preferably within 24 hours of the initial diagnosis, but recommended up to 14 days after the diagnosis of illness.