Rapid reaction: What is meningitis B?

Over a dozen people are seriously unwell in hospital and two people have died from an outbreak of meningitis in the UK, according to reports from the UK Health Security Agency.

It’s believed that the illness may have spread during an event attended by students in Kent. As of 17 March, six cases have been confirmed to be meningitis B through laboratory testing.

Meningitis is an infection of the meninges, the protective membranes that surround the brain and spinal cord. Meningitis B is a serious bacterial infection caused by Neisseria meningitidis group B, which can lead to life-threatening illness and bloodstream infections.

Meningitis affects around 2.3 million people globally every year and it’s estimated that up to one in every 10 cases of bacterial meningitis in the UK is fatal, according to the NHS.

Meningitis B infections are preventable through vaccination and the MenB vaccine has been offered to babies and young children as part of the NHS routine vaccination schedule since 2015.

Explaining why the MenB vaccine is not currently offered as routine to students in the UK, Dr. Eliza Gil, Clinical Lecturer at the London School of Hygiene & Tropical Medicine (LSHTM) said, “It’s unlikely that these students will have protective immunity to meningitis B. The meningitis B vaccination has been recommended and offered to babies in the UK from 2015. This means that it is the strain that many current students will not have been vaccinated against.

“The MenB vaccine is given specifically to babies as they are the group at highest risk of death or serious illness, so this has been a deliberate decision to protect the most vulnerable. But unfortunately, this does mean that many current students won’t have immunity to meningitis B themselves.

“Currently, students aren’t offered MenB vaccination as part of a routine schedule because their risk has typically been low in comparison to young children and babies and also because the protection the vaccine offers is imperfect and is thought to only last a few years. However, this is something that affected patients and their families, alongside charities and bodies such as the National Union of Students, have openly campaigned for. In addition, some individuals are already obtaining the vaccine privately.

“The tricky thing with vaccines is that we learn a lot about the long term protection they offer by using them in the population. The MenB vaccine is relatively new, and has mostly been used in babies and very vulnerable individuals, so we don’t have as much information about how useful it is in young adults.

“Some families choose to access vaccination privately as it is commercially available on the high street from chemists. This creates a situation where currently we have unequal access based on ability to pay.

“Meningitis is now very rare in the UK in the era of vaccination but there are still cases every year. These often occur in adolescents and young adults because this is a bacteria that is carried in the throat and is spread through close contact. This is a phase of life when people are exposed to a lot of different people in very close proximity, both through their studies and the way they live in halls of residence, and often through social activities like this potential club exposure. But I think we can be reassured that the absolute risk is still low to people who have not had very close contact with anyone in the affected community.

“We have no concrete evidence at this stage that the sharing of vapes is implicated in this outbreak but it is something that I would always advise against. Vaping hasn’t been around long but we know that sharing cutlery, for example, has previously been identified as a risk factor for the spread of bacteria that lives in the mouth, so anything we can do to avoid this would always be a sensible step.”

Dr. Ben Kasstan-Dabush, Assistant Professor in Global Health & Development at LSHTM, said, “The meningitis outbreak is a profound reminder of the dangers of infectious diseases, particularly when young adults will be required to mix in educational settings and will often be in close contact.

“Infants have been recommended meningitis B vaccination since 2015, which means that students currently at university would not be covered but should call 111 or speak to their GP surgery if concerned.

“It is also essential to ensure that children and young people receive all NHS recommended vaccinations to protect them from those diseases that are vaccine-preventable.

“The school-age vaccination program protects adolescents against other common meningitis ACWY strains, because there is a risk of incidence peaking in 15 to 19 year-olds. Adolescents are also offered the tetanus, diphtheria and polio (Td/IPV), and HPV vaccinations.”

What is meningitis?

Meningitis is an infection of the membranes (meninges) and fluid that surround the brain. It can be caused by a small number of viruses, bacteria or occasionally fungi.

What is meningitis B?

Bacterial meningitis infections are often caused by bacteria called Neisseria meningitidis, often referred to as meningococcus.

Meningococcus meningitis can become serious very quickly and is associated with bloodstream infections, called septicemia or sepsis.

Within the species of Neisseria meningitidis there are different “types” and each are unique. Meningitis B is caused by Neisseria meningitidis group B bacteria.

Are there vaccines that protect against bacterial meningitis in the UK?

There are currently two Neisseria meningitidis vaccines recommended in the UK.

One, called the MenACWY vaccine, offers protection against the bacteria types A, C, W and Y and is routinely offered to students in secondary school in the UK.

The second, MenB, protects against type B bacteria and is routinely offered to babies and young children.

Some current students are unlikely to have protection against meningitis B, as the vaccination program for babies and young children in the UK did not start until 2015.

There are also other vaccines recommended in the UK that offer protection against different types of bacteria known to cause meningitis, including Hib and pneumococcal bacteria.

What are the symptoms of meningitis?

Meningitis typically causes headaches, neck stiffness and fever (high temperature), and can also cause drowsiness, nausea/vomiting and increased sensitivity to light. Some meningitis infections can cause a rash that does not disappear with pressure, but this is not always visible in the early stages.

How does meningitis B spread?

Neisseria meningitidis is most commonly found living in the throat. It is spread between people through close contact with secretions from the mouth or airway and usually requires close or prolonged contact between people for the bacteria to be transmitted.