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Indiana State Department of Health

ISDH Home > About the Agency > Schools Communicable Disease Guide > Meningococcal Disease (Meningococcal Meningitis or Meningococcemia) Meningococcal Disease (Meningococcal Meningitis or Meningococcemia)


Clinical Description
Meningococcal meningitis is an acute inflammation of the lining of the brain and spinal cord caused by Neisseria meningitidis (meningococcus) bacteria.  Symptoms include stiff neck, high fever, headache, nausea, vomiting, and possibly a petechial rash. Meningococcemia is a life threatening bloodstream infection caused by N. meningitidis.  Both meningococcal meningitis and meningococcemia are considered medical emergencies.

Incubation Period
The incubation period is short, ranging from 2 to 10 days, most commonly 3-4 days.

Mode of Transmission
Meningococcal bacteria are not particularly contagious.  Spread, when it does occur, is usually person-to-person by respiratory droplets from the nose and throat of infected people.  Saliva exchange is the most common method of transmission. Transmission is highest among household contacts.  Up to 10% of the general population are carriers of meningococcus.

Period of Communicability
A person who is untreated or a carrier can spread the bacteria until the meningococcus is no longer present in discharge from the nose and mouth.  The bacteria will disappear from the nose and throat within 24 hours after the initiation of appropriate antibiotic therapy.

Exclusion/Attendance
There are no specific exclusion provisions found in Indiana communicable disease laws or rules for meningococcal meningitis.  Almost all cases of meningococcal diseases are hospitalized and treated with antibiotics, which eliminates carriage.  Close contacts of cases that are considered high-risk should be given prophylactic antibiotics to prevent possible infection.  Asymptomatic contacts do not need to be excluded from school. For information on laws and rules regarding meningococcal disease see Rule 410 IAC 1-2.3 Sec. 85: at http://www.in.gov/isdh/files/comm_dis_rule.pdf

Prevention/Care

• Immediately call caregiver if student develops classic meningeal symptoms (fever, severe headache, stiff neck) and provide education concerning urgency of receiving medical evaluation.
• Prophylactic antibiotic treatment is needed for high risk close contacts and family members and should be started within 24 hours of a suspected case of meningococcal disease.
• Prophylactic antibiotic treatment is not recommended for school contacts in most circumstances – consult local or state health authorities for guidance regarding who should receive prophylaxis. 
• Consider sending letter to parents (sample letter available from the ISDH).
• Meningococcal vaccine is recommended for all persons between the ages of 11 and 18 years and young adults planning to live in college dormitories or military barrack settings.  School immunization requirements for meningococcal diseases can be found at: http://www.in.gov/isdh/17094.htm
• Schools are required to notify parents each year about meningococcal disease and the availability of meningococcal vaccine.  See IC 20-30-5-18 at: http://www.in.gov/legislative/ic/code/title20/ar30/ch5.html

Other Resources
Indiana State Department of Health Quick Fact Link:
http://www.in.gov/isdh/healthinfo/meningococcal_disease.htm

Centers for Disease Control and Prevention (CDC) Link:
http://www.cdc.gov/ncidod/diseases/submenus/sub_meningitis.htm