What Is Meningococcal Meningitis?

Medically Reviewed by Poonam Sachdev on March 28, 2024
7 min read

Meningococcal meningitis is a rare but serious bacterial infection. It causes dangerous inflammation in the membranes that cover your brain and spinal cord. These are called the meninges.

Any type of infection caused by the Neisseria meningitidis bacteria is known as meningococcal disease. The two most common types are meningococcal meningitis and meningococcal septicemia (a blood infection).

Meningococcal disease has become less common in the U.S. than it once was, with fewer than 500 cases reported in 2023. But it can be fatal or cause great harm without prompt treatment. According to the CDC, even with antibiotics, 10%-15% of those infected will die, and about 1 in 5 of those who survive are left with long-term disabilities that include deafness, brain damage, neurological problems, and loss of a limb.

Neisseria meningitidis, also called meningococcus, is the most common cause of bacterial meningitis in children and teens. In adults, it's the second most common cause.

In many people, the bacteria live in the back of the nose and throat without causing any problems. For unknown reasons, it can sometimes break through your body's protective barriers and get into your bloodstream. From there, it can reach your nervous system and cause meningococcal meningitis. Bacteria can also enter your nervous system directly after severe head trauma, surgery, or infection.

Meningococcal meningitis can spread through saliva and mucus. That takes direct contact, such as kissing or coughing in someone's face. The bacteria doesn't live long outside your body, so you aren't likely to get infected by touching a surface that a sick person has touched. It's been known to spread easily in places where people live in close quarters, such as college dorms and military barracks.

Bacterial meningitis is different from viral meningitis in that it is much less common and much more serious. So if you or your child is having symptoms, it's important to figure out exactly which infection you have.

Only a small percentage of people exposed to the meningococcus bacteria will get sick. Certain things make it more likely, including:

  • Your age. Infants and young children account for most cases, followed by teenagers and young adults, and the elderly.
  • A weakened immune system, from things such as medication, HIV infection, sickle cell disease, or having your spleen removed
  • Being unvaccinated
  • Close contact with an infected person
  • Living in crowded conditions with young people

A meningococcal infection can get worse very quickly, so it's important to be on the lookout for symptoms and get to a doctor right away.

The most common symptoms of meningococcal meningitis are:

  • Sudden high fever
  • Severe, persistent headache
  • Neck stiffness
  • Confusion or other mental changes

Other possible symptoms include:

In babies, symptoms can be slightly different. Watch for:

  • A tense or bulging soft spot on their skull (fontanelle)
  • A high-pitched or moaning cry
  • Stiff, jerky movements or floppiness
  • Irritability
  • Lethargy or excessive sleepiness
  • Vomiting
  • Feeding poorly

Meningococcal septicemia

A very important sign to watch for is a reddish or purple skin rash known as petechiae, indicating that bacteria have entered your bloodstream. You can tell this kind of rash from other kinds because the spots don't get lighter when you press on them. (Try pressing on the spots with something you can see through, like a glass.)

This is a medical emergency. The rash spots are blood that has leaked from your blood vessels because of damage caused by the bacteria. Infection in your bloodstream is called meningococcal septicemia, and it can become fatal within hours.

Other signs of septicemia include:

  • Leg pain
  • Fast breathing
  • Blotchy skin, turning pale or blue
  • Shivering
  • Cold hands and feet

As it progresses, septicemia causes blood clots to form in the blood vessels that supply oxygen to your skin, organs, and other tissues. That can lead to scarring, limb amputation, and organ failure.

Meningococcal meningitis can cause death or serious complications. Brain swelling, blood clots, and toxins released into your blood can damage brain and nerve cells. There may be lifelong effects, including:

  • Memory problems
  • Learning disabilities
  • Behavioral problems
  • Trouble walking
  • Paralysis
  • Deafness
  • Epilepsy

To prevent these problems, it's important to act quickly. Do not wait. Seek immediate medical attention. Go to an emergency room or call 911 if:

  • You notice symptoms of meningococcal meningitis.
  • Symptoms do not improve with treatment.
  • You think you've been exposed to meningococcal meningitis.

If they suspect meningococcal meningitis, doctors will probably immediately start you or your child on antibiotics through a needle placed in a vein (IV) while they run tests to be sure of the diagnosis. You'll likely have:

Blood tests. These are done to measure the count of your red and white blood cells, see how quickly your blood clots, and check for bacteria in your blood.

CT scan. This can show swelling or bleeding in your brain and reveal problems that could make it risky to get a sample of spinal fluid.

Spinal tap. A small sample of spinal fluid is collected with a needle inserted into your spinal column. It gets tested for bacteria.

The treatment for meningococcal meningitis is antibiotics, such as penicillin or ceftriaxone, given through an IV, usually for 5-7 days. Doctors sometimes also prescribe steroids and other medicines to control brain swelling.

You or your child may need other emergency care to treat problems related to the infection, like low blood pressure. This can include:

  • IV fluids
  • Medications to raise your blood pressure
  • Breathing support

Depending on how sick you are, you may need intensive care and have to spend a week or more in the hospital.

If you or someone you love has come in close contact (through saliva or other oral secretions) with someone who has meningococcal meningitis — such as at school, day care, work, or home — it's very important to get antibiotics to prevent infection.

Meningococcal meningitis is a serious disease, even with treatment. That's why prevention is a far better approach. The meningococcal vaccine can prevent meningitis infection. In the U.S., three types of meningococcal vaccines are used:

Meningococcal conjugate vaccines (MenACWY or MCV4). One of these vaccines, Menveo, is approved for anyone aged 2 months to 55 years, while the other, MenQuadfi, is used for those aged 2 years or older.

Serogroup B meningococcal B (MenB) vaccines. There are two MenB vaccines. Trumenba (MenB-FHbp) and Bexsero (MenB-4C). Both are approved for ages 10-24 but can be used in older patients, too.

Pentavalent meningococcal vaccine (MenABCWY). Penbraya is an option if you need both the MenACWY and MenB vaccines at the same time.

Although they can't prevent all types of meningococcal disease, the vaccines can prevent many types of the disease.

Experts recommend a dose of MenACWY, which is given as a shot, for children at age 11, and then a booster shot at age 16. If the first dose is missed, the MenACWY vaccine can be administered between ages 13 and 15, followed by a booster dose between ages 16 and 18.

A MenB vaccine is recommended for anyone aged 10 or older who's at high risk.

Other people at risk should also consider getting one or both types of the vaccine. Those at risk include:

  • People who think they've been exposed to meningococcal meningitis
  • College students living in dorms
  • U.S. military recruits
  • Travelers to areas of the world, such as Africa, where meningococcal disease is common
  • People with a weakened immune system because of a damaged spleen, HIV, or terminal complement component deficiency, which is an immune system disorder
  • People taking drugs called C5 inhibitors 
  • Lab personnel who are often exposed to the meningococcal bacteria

Wait to get vaccinated if you're very ill at the time you're scheduled for the shot. Avoid the vaccine if you've had a severe allergic reaction to a previous dose, or have a severe allergy to any vaccine component.

Mild pain, swelling, or redness at the injection site is common and should not be a problem. But call your doctor right away if you have a strong reaction to the vaccine. This includes a high fever, weakness, nausea or diarrhea, or signs of an allergic reaction, such as trouble breathing, a fast heartbeat, or dizziness.

Meningococcal meningitis is a very dangerous and contagious infection that causes inflammation in the membranes covering your brain and spinal cord. If you think you've been exposed, or if you have symptoms such as a sudden high fever, severe headache, stiff neck, or sensitivity to light, get to an emergency room right away. Even with treatment, it can be fatal or cause lifelong complications. A vaccine can protect you from most types of the disease.

How do you get meningococcal meningitis?

The bacteria that cause meningococcal meningitis spread through an infected person's saliva or mucus. It takes close contact, such as kissing or being coughed on.

What is the difference between meningitis and meningococcal disease?

Meningitis is an infection that causes inflammation around your brain and spinal cord. You mainly get it through a virus, but it can also come from bacteria, parasites, or fungi. Meningococcal disease, caused by the Neisseria meningitidis bacteria, can include meningococcal meningitis (a form of bacterial meningitis) and meningococcal septicemia (a blood infection).

What causes meningococcal meningitis rash?

The rash that can go along with meningococcal meningitis (called petechiae) comes from blood leaking into your tissues because of damage to your blood vessels. It indicates blood poisoning and is a medical emergency that needs immediate treatment.