Meningococci are special bacteria that can cause serious illnesses in humans, such as meningitis or blood poisoning (sepsis). The pathogens can be divided into different categories, so-called serotypes, based on their surface structure. In Germany, serotypes B, C, Y and W are primarily responsible for the majority of diseases.
The germs are transmitted through droplet infection, for example when coughing or sneezing. Often, meningococcal infestation does not cause any symptoms – in around ten percent of the healthy population, the bacteria settle on the mucous membranes in the nasopharynx. In people with weakened immune systems or small children, however, the pathogens can, for example, enter the bloodstream and lead to an “invasive” meningococcal infection with severe inflammation. Sick people are contagious from about seven days before the onset of symptoms and up to 24 hours after starting antibiotic treatment.
According to the Robert Koch Institute (RKI), an invasive meningococcal infection initially manifests itself through non-specific symptoms: dizziness, headaches, chills and fever. These can develop into a life-threatening condition within a few hours: meningitis, which can be accompanied by, among other things, irritability, drowsiness, vomiting, stiff neck as well as seizures or cranial nerve paralysis. In small children, meningitis is often less characteristic. In addition to the symptoms mentioned above, a bulging or hard fontanel (gap between the skull plates) may occur, but the often typical neck stiffness may be absent. In this country, an invasive meningococcal infection leads to blood poisoning in two thirds of cases: This manifests itself as skin bleeding, a drop in blood pressure and organ failure. In rarer cases, severe infection can also lead to inflammation of the lungs, heart muscle, inner lining of the heart, pericardium or bone marrow.
Due to the initially very unspecific symptoms, an invasive meningococcal infection is often only recognized late. It is rare: nationwide, fewer than 0.4 new illnesses occur per 100,000 inhabitants per year. However, this serious illness is fatal in around eight percent of cases. In addition, around a quarter of survivors suffer from long-term consequences such as chronic kidney failure, epilepsy, hearing loss or psychological disorders. If you are unsure or suspect a meningococcal infection, you should be admitted to hospital immediately.
Infants have the highest risk of developing a meningococcal infection – followed by small children under five years of age and adolescents aged 15 to 19 years. Serotype B meningococci are among the main causes with more than 51 percent, followed by serotype C meningococci with 13 percent. Between 2015 and 2019, around 3.5 per 100,000 infants and 1.0 per 100,000 young children aged one to four years fell ill each year. Afterwards, the protective measures to contain the Sars-CoV-2 pandemic were also reflected in a disproportionate decline in the number of cases of meningococcal infections. From autumn 2022, after the end of the contact restrictions, they increased significantly again. Another risk group includes – in addition to people with a congenital or acquired immune deficiency – people at risk at work, such as medical staff.
Since the risk of disease is highest in early childhood, early vaccination is the best possible protection against meningococcal disease. The Standing Vaccination Commission (Stiko) has been recommending vaccination for children from the age of two against meningococcal serotype C since 2006; Otherwise, this vaccination should be done by your 18th birthday at the latest. Since January 2024, Stiko has also recommended vaccination against meningococcal serotype B for all infants from the age of two months; This vaccination should be given by the time you reach the age of five. The Stiko does not make a general vaccination recommendation against meningococcal serotype B for young people – the age group with the second highest peak of disease – or all other age groups. In addition, people at increased risk of invasive meningococcal disease should be vaccinated with a combination vaccine against meningococci serogroups A, C, W and Y and with a meningococcal B vaccine.
