A sixth-form pupil and a university student in Kent have died and 11 people are believed to be seriously ill in hospital after an outbreak of a rare form of invasive meningitis. We take a look at the disease, and how the situation is being managed.
What has caused the outbreak?
Meningitis is a serious condition in which the membranes surrounding the brain and spinal cord are infected with bacteria or a virus and become inflamed. It can come on suddenly and can be fatal.
The current outbreak appears to involve invasive meningococcal disease. This is caused by meningococcal bacteria that have caused meningitis as well as septicaemia, or blood poisoning.
What are the symptoms?
Early symptoms can include a sudden onset of fever, a stiff neck and a rash that does not fade when a glass is rolled over it. They can also include a severe headache, aversion to bright lights, vomiting and diarrhoea, seizures, joint and muscle pain, confusion and extreme sleepiness.
However, as the UK Health Security Agency (UKHSA) points out, these symptoms may not always be present.
Viral meningitis can get better on its own but bacterial meningitis is more serious – about one in 10 cases are fatal – and often needs hospital care, with treatments including antibiotics, fluids and oxygen.
While most people make a full recovery from meningitis if treated promptly, the bacterial form of the disease can result in long-term complications such as problems with hearing or vision, epilepsy and difficulties with memory, concentration and balance, and in some cases it may require the amputation of limbs.
Can it be prevented?
There are routine vaccinations to help protect against viral and bacterial meningitis. As the NHS notes, the MenB vaccine, 6-in-1 vaccine, pneumococcal vaccine and MMRV vaccine are offered to babies or young children, although UKHSA has pointed out the MenB vaccine does not protect against all strains of the MenB bacteria.
In addition, the MenACWY vaccine, which covers four other meningococcal groups, is offered to teenagers in school years 9 and 10 and can be given until the age of 25.
Prof Andrew Preston, of the University of Bath, said: “Uptake of the ACWY vaccine among adolescents is around 73%, so there are a lot of unvaccinated students given the size of the student cohort.”
People who have missed these vaccinations can contact their GP to check which ones they are eligible for and arrange catchups.
However, these vaccines do not protect against all of the possible viruses or variants of bacteria that can cause meningitis.
Dr Zina Alfahl, of the University of Galway, said: “Whether vaccination rates played a role in this outbreak will depend on which strain is involved, which hasn’t yet been confirmed. Until that information is available, it would be premature to attribute the outbreak to vaccine uptake.”
Brian Davies, the head of health insights and policy at the Meningitis Research Foundation, said: “Determining the strain of meningitis is not always easy and can depend on the samples available and the testing required. UKHSA’s meningococcal reference unit says PCR results are typically available within one to two working days of receipt, while full characterisation of isolates, including typing, can take up to 10 working days. In some cases, preliminary information may be available sooner.”
Who is typically affected?
Anyone can get meningitis and it can crop up in unconnected individuals, but young people – such as those going to college or university – tend to be more at risk. As the UKHSA notes, that’s because they mix with lots of other young people who may be carrying the bacteria that cause meningitis.
Alfahl said: “The bacteria are often carried harmlessly in the throat, especially among teenagers and young adults.” These bacteria, which often colonise the nose and throat without causing disease, can be passed on through sneezing, coughing or kissing.
“University environments – halls of residence, parties and large social networks – create conditions where the bacteria can spread more easily. That’s why vaccination programmes and rapid public-health responses often focus on students and young adults when clusters occur,” Alfahl said.
According to the BBC, the outbreak is thought to be linked to a social event in Canterbury that was attended by some of those who later became ill.
Trish Mannes, UKHSA’s regional deputy director for the south-east, said students were particularly at risk of missing early symptoms of the disease because they could resemble a bad cold, flu or a hangover.
“That’s why it’s vital that if a friend goes to bed unwell, you check on them regularly and don’t hesitate to seek medical help by contacting their GP or calling NHS 111 if they have these symptoms or you’re concerned about them. This could save their life,” she said.
What is being done to manage the situation?
Public health teams have already swung into action, with UKHSA specialists interviewing affected individuals and their families to help identify all close contacts and arrange antibiotics to limit spread.
Mannes said: “Students and staff will understandably be feeling worried about the risk of further cases. However, we would like to reassure them that close contacts of cases have been given antibiotics as a precautionary measure. Advice and support is being offered to the wider student community, and to local hospitals and NHS 111, and we’re monitoring the situation closely.”
UKHSA adds that anyone who thinks they, or someone they care for, could have meningitis, septicaemia or sepsis should call 999 or go to their nearest A&E.
