Over three weeks, from mid-August into September, three children from far north Queensland developed meningococcal disease.

This was a life-threatening infection caused by the bacteria Neisseria meningitidis.

According to the World Health Organisation, this same bacteria in other parts of the world is the form of meningitis “with the potential to produce large epidemics”.

That’s highly unlikely to occur in Australia.

Even so, a doctor from Queensland Health declared the situation in and around Cairns as a “major outbreak” – describing it as “unusual and fairly significant”.

Meanwhile, an adult and a child have been treated in hospital with meningococcal disease in Western Australia. There have been nine cases in WA this year, including a man who died in April.

According to an article published this week at The Conversation, there have been more than 80 meningococcal infections recorded across Australia this year.

“Although meningococcal disease can occur all year round, in Australia this infection occurs most commonly in late winter and early spring,” it read.

An average of 10 cases a month is disturbing, for good reason.

The problem isn’t primarily one of numbers, it’s the difficulty of dealing with a disease that undoes a person in short order.

You can seem perfectly well at breakfast, and be dead by dinner time.

Where does the bug come from?

The Neisseria meningitidis is but one of many bugs you can find living harmlessly, from time to time, at the back of your throat.

According to WHO, between 5 and 10 per cent of the population carries Neisseria meningitidis in their throat at any given time. The bacteria only infects humans.

The signs and symptoms to watch for. Image: Getty

It can spread from person to person, via saliva, during a long period of close contact, or instances of intimacy. It can be spread as droplets in a sneeze or a cough.

But there’s an element of bad luck here. The bacteria isn’t that easily spread because it survives for a very short time once out of the body.

So what is meningitis?

Invasive meningococcal disease refers to the range of invasive diseases caused by Neisseria meningitidis, including septicemia, arthritis and meningitis.

Meningitis is a devastating infection of the meninges, the membranes covering the brain and spinal cord.

The average incubation period is four days but can range between two and 10 days.

The most common symptoms of meningitis are a stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting.

In young children, fever, pale or blotchy complexion, vomiting, lethargy, floppiness and lack of appetite are signs that medical care is required immediately.

According to The Conversation: “Sometimes, meningococcal disease can also cause a characteristic rash that doesn’t disappear when pressure is applied. It may start as red or purple pin-prick spots, or as small bruises.”

But not everyone with meningococcal disease will present with a rash. And when it does occur “it’s often a late sign, indicating the infection is well advanced”.

Infants, toddlers, adolescents, Aboriginal and Torres Strait Islander people, young people who live in close quarters, and people who smoke are at a higher risk.

Kills up to one in 10

According to WHO, “even with early diagnosis and adequate treatment, 5 to 10 per cent of patients die, typically within 24 to 48 hours after the onset of symptoms”.

Bacterial meningitis can result in brain damage, hearing loss or a learning disability. These can occur in 10 to 20 per cent of survivors.

Meningococcal septicaemia, which is characterised by a hemorrhagic rash and rapid circulatory collapse, is often fatal.

Vaccination

There are a number of strains or serogroups of Neisseria meningitidis. 

There are different types of the N. meningitidis bacteria, called serogroups. They’re slightly structured differently from one another.

In Australia, we have a vaccine that protects against serogroups A, C, W and Y (ACWY).

According to The Conversation, these serogroups cause most of the meningococcal disease around the world.

The ACWY vaccine has been available for free under Australia’s National Immunisation Program since 2018. It’s given at 12 months of age, and at age 14 to 16.

There is a vaccine that protects against serogroup B. It’s recommended for all children but is only available for free under the National Immunisation Program for certain people.

This includes Aboriginal and Torres Strait Islander children under two and people with certain medical conditions.

Queensland funds a program to provide free meningococcal B vaccines to all infants and children aged six weeks to two years, and adolescents aged 15 to 19. But there has been a low take-up.

South Australia funds meningococcal B vaccination for infants under one, alongside a school program for year 10 students.

Elsewhere, for children not meeting the high-risk criteria, “the meningococcal B vaccine needs to be purchased on a private script”.

Many parents “aren’t aware of this vaccine, and cost can be a barrier too”.

This has created a situation where only people who can afford the vaccine (about $100 a pop) can protect their children.

Last week, Professor Robert Booy, infectious diseases paediatrician, published a piece calling for “equitable access to meningococcal vaccines”.

“Is it fair that some Australian children are protected from a rare but serious, life-threatening infection and others are not?” he wrote.