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see also New York Health Department sheet
Also DHS Victoria - meningococcal disease (diagnosis & treatment group B & C)
Disease outbreaks: http://www.who.int/emc/outbreak_news/index.html
International travel and health 2002 - pages107 & 108

MENINGOCOCCAL MENINGITIS .. immunisation menu

This disease is an important cause of overwhelming sepsis in otherwise healthy young people and has a fatality rate of approx 10%. The time interval between close contact with a carrier to the onset of clinical illness is usually 5-7 days.

Meningitis risk occurs in

• Most of the African states:- high risk time is during the dry season (especially Dec to Feb),
• India:- high risk time in India (especially near Delhi) is from Nov to April
• Mongolia, Nepal, Pakistan, Vietnam.
• Egypt, Persian Gulf States, Saudi Arabia,
• Brazil, Cuba

The Saudi Arabian authorities require all visitors to holy places (pilgrims to the Hajj and for Umra performers) to posses a valid certificate of vaccination received 10 days to 2 years prior to date of arrival. An excellent alternative to vaccination is ciprofloxacin.

Vaccination - Menomune (CSL) & Mencervax (GlaxoSmithKline)
Product information -  immunisation against meningococcal meningitis (groups A, C, W135, Y) in adults, children > 2 years: close contacts of patients with disease; travellers to epidemic, endemic countries; epidemic control in confined communities; high risk of acquiring meningococcal infection (incl. anatomic or functional asplenia)

• 0.5 mls single subcutaneous injection for all ages
• Can be given concurrently with most other vaccines - possibly more side-effects if given with pertussis or typhoid vaccination. (give 4 weeks apart)
• 90% protection after 14 days in recipients over the age of 2
• Side-effects - vaccine very safe - some redness, pain for 1 - 2 days, 2% have high fever *
• Children under 2 should have 2 doses 3 months apart but protection against serotypes A & C is poor. - consider Meningitis C vaccination 2 weeks before above *
• Protection lasts 3 - 5 years but only 12 months in under 4 age group
• Avoid in Pregnancy unless risk of infection substantial.

Information mostly taken from: "International Travel and Health" (WHO year book - internet only)
Australian Immunisation Handbook, 8th Edition - 9/2003 - Part1 - Part 2 & Part 3 (large pdf files)
Centre for Disease Control, USA -  www.cdc.gov/travel Travel Health Seminar Oct 96, June 97,Feb 98, March 99, May 2000, August 2002 & March 2005 - Victorian Medical Postgraduate Foundation.
Manual of Travel Medicine, Melbourne, Oct 2004. Updated 18/09/2005.  Additional references & disclaimer.

  Last Update: 14-Sep-2005