Health officials have confirmed that meningitis B is the strain identified in some of the cases in Kent, in an outbreak that has killed two young people and has left 11 others in hospital.
What is meningitis B?
Meningitis is an infection of the protective lining of the brain and spinal cord. It is caused by different bacteria and viruses. Meningitis B, known as MenB, is the most common form of invasive meningococcal disease. It is caused by the Neisseria meningitidis bacteria, also known as the meningococcus.
This bacteria usually lives harmlessly in people’s throats, but can cause life-threatening disease if it gets into the blood or spinal fluid.
What are the symptoms?
MenB can progress rapidly. Early symptoms are not always present, but can include a sudden high fever, a stiff neck, severe and worsening headache and a rash that does not fade when pressed with a glass. They can also include aversion to bright lights, vomiting and diarrhoea, seizures, joint and muscle pain, delirium and extreme sleepiness.
How serious is it?
MenB can be fatal. The meningococcal bacteria can cause inflammation of the lining of the brain and septicaemia, which can rapidly lead to sepsis. If caught early and treated with antibiotics, most people will make a full recovery. But about one in 10 people infected die, and it can cause long-term complications such as hearing loss, amputation, epilepsy or learning disabilities.
How contagious is it?
MenB is spread by prolonged and close contact – typically through coughing, sneezing and kissing. According to Prof Paul Hunter at the Norwich School of Medicine, University of East Anglia, teenagers’ increased risk is often associated with moving away from home and living in crowded conditions.
“About 10% of people carry the bacteria at any one time and this is even higher in adolescents,” he said. “The infection is spread between people during close contact such as living in the same household or whilst kissing (mouth to mouth).”
He added: “There is a lag from exposure to when people get ill, which is typically under a week, but can be as long as 10 days.
“If you had a single case, you would tend to only contact the family and give antibiotics to them. If you had two cases in a class, in a school, you would give antibiotics to the whole class. If you had two cases in a school, not in the same class, you would give antibiotics to the whole school.
“When you realise you have a significant problem, getting antibiotics into people is important. You can go from being mildly ill walking around to being dead in less than a day.”
Hunter said that seeing a cluster of cases was not unusual, with 300-400 cases of invasive meningitis typically recorded in a year. “We see clusters all the time,” he said. “What’s unusual is the size of this cluster. That’s the scary thing.”
It is not clear what has led to such a large outbreak. “It could be that there is a new more virulent strain, or due to what was happening at the nightclub,” Hunter said.
Can you get MenB from sharing a vape?
If you share a vape you transfer saliva between you. It is therefore considered a high-risk for transmitting bacteria and viruses, alongside sharing toothbrushes or drinks, because vapes come into direct contact with the mouth. One mother of a girl in hospital with the disease said she suspected her daughter caught it from a vape.
Simon Williams, public health researcher and lecturer in the College of Human and Health Sciences at Swansea University, said: “Sharing vapes would be one way in which the meningitis bacteria could be spread. Generally, this disease is spread via respiratory droplets – which could include kissing, or sharing drinks, vapes or also coughing and sneezing, and being in very close contact. Things like close contact singing and talking also might spread it as one might find in crowded indoor settings like nightclubs – provided infected respiratory droplets are passed between people. This is part of why we see cases at settings like university halls and nightclubs.”
Gayatri Amirthalingam, the deputy director of the immunisation and vaccine preventable diseases at the UK Health Security Agency (UKHSA), told BBC Radio 5 Live that people should not share vapes.
“Sharing anything that goes in your mouth is a potential risk factor for transmitting a mouth-living bacteria. So for definite I would be not recommending vape sharing in general from a hygiene point of view. But also in this context it seems an easy enough thing to stop doing, even if we’re not sure if it was causative in this case.”
How is it treated?
Treatment for meningitis includes antibiotics, intravenous fluids, oxygen if there are breathing difficulties, and in some cases steroid medication to prevent swelling around the brain.
Is there a vaccine?
Since 2015, the MenB vaccine is offered to babies at eight weeks, with a second dose at 12 weeks and booster at one year. Other routine childhood jabs, including the 6-in-1 and pneumococcal vaccines, can protect against meningitis. 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. But teenagers born before 2015 are unvaccinated against MenB.
Why haven’t teenagers been vaccinated?
The Joint Committee on Vaccines and Immunisation committee recommends which vaccinations should be given to which people, based on latest research on prevalence, effectiveness of the vaccine and cost effectiveness.
Despite MenB accounting for 80% of cases of invasive meningococcal disease, until now, the JCVI has not deemed MenB vaccination to be cost-effective for teenagers because it doesn’t prevent the bacteria from spreading from one person to another, it doesn’t target against all the different B bacteria strains and doesn’t protect for particularly long either.
Meningitis Now says young people should be vaccinated against meningitis B on the NHS, with the most at risk inoculated first, followed by a booster programme for teenagers from 2030. Private jabs should also be made more affordable, it argues. Private meningitis B vaccinations cost between £100 and £120 a dose in the UK, with a full two-dose course costing about £200-£240. Boots offers two doses for £220.
Should teenagers living near the Kent outbreak be vaccinated?
Some experts believe that catchup jabs could help reduce the risk of further outbreaks. Prof Emma Wall, clinical research group leader at the Francis Crick Institute, and clinical professor of infectious diseases at the Blizard Institute, QMUL, said: “Vaccination can be a very useful tool to reduce onward transmission of this bacteria and reduce the risk of a secondary outbreak in students or related communities. Protection from the vaccine is rapid.”
What should you do if you think you’ve been exposed to MenB?
The UKHSA says that anyone who becomes unwell with symptoms of meningitis and septicaemia should seek medical help urgently at the closest A&E or by dialling 999. Those who attended Club Chemistry in Canterbury between 5 and 7 March should come forward for antibiotic treatment.
