Meningitis Risk Shifting from Infants to Teens - New Data

New Institute of Environmental Science and Research (ESR) data shows the number of cases of meningococcal disease among Kiwi teenagers and young adults has increased by 88% over the same time last year.

Māori youth are among those experiencing the largest increases in case numbers, with three times as many recorded as the previous year. The figures also show a significant lift in the number of cases among European teens, with males up 67%.

Meningococcal disease is an uncommon but life-threatening bacterial infection causing two serious illnesses: meningitis (an infection of the membranes that cover the brain) and septicaemia (blood poisoning).

Despite medical care, around one in every ten patients who contract the disease will die, and up to one in five survivors will have permanent disabilities, such as brain damage, amputated limbs and hearing loss.

There are several types or serogroups of meningococcal bacteria including groups A, B, C, W and Y. The most common in New Zealand is meningococcal group B.

New ESR data shows Māori and Pasifika infants and toddlers made up the majority (55%) of cases last year but there has been a shift in the burden to the 15-29 demographic. Last year those aged between 15-29 made up 16% of cases. For the same period this year, they make up 35% of all cases.

The number of infants (aged under 1) with the disease has fallen by 60% over the same time last year while the number of 15-29-year-olds with meningococcal disease has risen by 88%.

The Meningococcal B vaccine is funded for those 13-25 who are entering within the next three months or in their first year of close-living situations such as hostels, boarding schools, halls of residence and the military, which had a one-year catch-up programme for young people already living in closed-living environments, this catch-up programme will end on February 28, 2024.

It is also funded as part of scheduled childhood immunisations with a catch-up programme running for another year and a half to provide vaccination for all children under the age of five.

This vaccine was previously only funded for those with reduced immune function or close contacts of a meningococcal case.

Medical professionals are warning that with a new cohort of teenagers about to end their school year and head off to flats and university halls it's essential they have been vaccinated for their protection.

Woodford House school nurse Caryn Williams, says at the beginning of each school year she sends out a communication to all parents outlining details on the two meningococcal vaccines.

“We send out a specific consent form along with a cover letter noting the importance of the vaccines, particularly for those in the boarding houses, but we also make it available to day girls.

“We are trying to do our bit to protect our students and I understand some of the universities strongly recommend students to be vaccinated for meningococcal disease before they enter the halls of residence. Our concern is also for other students who may end up in flats and who may not be protected.

“Students need to understand the importance of hygiene around meningococcal disease as it is passed via respiratory droplets and saliva. So regular hand-washing, sneezing into elbows or tissues and keeping a flat clean is also important.

“Without mum and dad there keeping an eye on things flats may not be as clean as at home. Often students are living in close confines and potentially sharing cutlery, glasses, other drinks, or toothbrushes and this could potentially be putting them at risk,” she says.

Williams says often flatmates will assume that someone who is ill could simply be suffering from COVID, the flu or a hangover, but they need to be vigilant and act quickly as the disease can take a life within 24 hours.

She says the symptoms of meningococcal B can be difficult to diagnose but can progress quickly. Along with headaches, fever, and a sore neck, patients may also present with a rash.

Williams says the new data shows that along with tertiary students or young adults in flats, school students are at heightened risk of developing the deadly disease.

“Year 12 and Year 13 students are incredibly social. By this age they’ve often had balls to go to and are regularly attending parties, music festivals and events with large numbers of people. There are numerous risk factors in these environments including sharing of vapes and beverages. Once they’ve had a couple of drinks they tend to lose their inhibitions and are more cavalier with their health.

“As a medical professional, I would feel awful if one of our students left our gates only to contract a disease that we now have vaccines for. It is a devastating disease and it has a lasting impact on those who contract it and their wider whānau,” she says.

Williams advises those parents who are unsure of their child’s vaccine status to check with their GP or school nurse.

Brett Marett, country medical director at GSK NZ, says New Zealand has a higher rate of invasive meningococcal disease compared with other developed countries.

Marett says he would encourage all parents and healthcare providers to prioritise vaccinating those at risk of contracting this disease.

“The latest data showing the elevated risk of meningococcal disease to teens is concerning as this cohort tends to be socially active which can increase the spread of the disease among peer groups.

“As we head into the busy summer season it can be easy to put our health to one side but those at risk must be protected ahead of exposure - which is the start of the school and university term,” he says.