HEALTH

A Deadly Strain Of Meningococcal Is On The Rise

'I felt unwell in the morning... by that night I was on life support.'

25/08/2017 12:17 PM AEST | Updated 25/08/2017 12:18 PM AEST

Meningococcal is a word likely to invoke terror in any parent, but an ever deadlier strain of the disease, which mostly affects adults, is on the rise in Australia -- and most of us aren't vaccinated.

A previously rare disease, the W strain emerged as the most common type of meningococcal in 2016, infecting 109 people across Australia.

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Lloyd Dunham, 19, died suddenly from meningococcal W while visiting his sister in Tasmania.

It is this strain which on Saturday claimed the life of West Australian teenager Lloyd Dunham, who died from meningococcal W during a family trip to Tasmania.

His sister Lucy told Seven News that the 19-year-old was on his way to the airport to return to WA when he had trouble breathing and passed out.

Dunham never regained consciousness. Within hours, he was dead.

He is the third person to die from the W strain so far this year, and with cases generally spiking in late winter and spring, health experts warn there will likely be more fatalities.

Just four days after his death, another West Australian man has been diagnosed with the same deadly strain.

"The rates of meningococcal disease in Australia are steadily increasing," the director of Meningococcal Australia, Eliza Ault-Connell, told HuffPost Australia.

"This year-to-date, we've more than reached our total for the same time last year so coming into the peak season now -- which is late winter, early spring -- this is really quite concerning.

"We could potentially double our rate of meningococcal disease in 2017."

Meningococcal W, C, B: What's The Difference?

Up until the late 1990s, meningococcal C was the most common strain to cause infections in Australia. But in 2003 the government introduced a vaccine to the National Immunisation Plan for all babies at 12 months, all but wiping out the disease in Australia.

Since then, meningococcal B has been the most prevalent -- until now.

In 2003, the W strain accounted for only 1.6 percent of all meningococcal patients, with just five people affected nationwide. But by 2016, the number of people developing it had reached 109 cases -- or more than 40 percent of all instances of meningococcal.

I felt unwell in the morning -- I had some symptoms of fever and vomiting and headaches -- and literally by that night I was on life support."

In Tasmania, where Lloyd Dunham contracted the disease, it accounts for 83 percent of all meningococcal cases so far this year.

Worryingly, this appears to be caused by a rise in a hypervirulent form of meningococcal W, called ST11.

Unlike other types of meningococcal -- which more frequently infect young children and those with a weakened immune system -- ST11 attacks healthy adults of all ages.

According to the Meningitis Research Foundation, around one in seven people who develop the ST11 strain will die.

So What Exactly Is Meningococcal?

"Meningococcal disease is an acute bacterial infection that can cause death within hours if left untreated," Ault-Connell explained.

There are 13 strains, all caused by the bacteria Neisseria meningitidis (also known as meningococcus), but the five main ones are A, B, C, W and Y. Without life-saving antibiotics, the disease will kill around half of its victims. Currently in Australia, around 5 percent of people who contract the disease die, and one in five will be left permanently disabled.

Around ten percent of the population carry the bacteria in the back of their nose and throat without developing any signs or symptoms of the disease, which means you don't have to come in contact with someone with the actual disease to be infected.

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Meningococcal is caused by the invasion of a bacteria called Neisseria meningitidis -- also known as meningococcus. It can infect the brain and spinal cord and get into the blood stream, where it multiplies rapidly.

Meningococcal can be spread by anyone with the meningococcus bacteria, generally via prolonged kissing, sneezing and coughing -- but it takes prolonged exposure for the infection to spread.

"We used to believe that it would spread through sharing of drinks and things like that, but now we know that's less likely to be the case," Ault-Connell said.

One of the scariest elements of meningococcal is the speed at which it can take over the body.

"We've seen people that have been relatively healthy in the morning and at death's door by dinner," Ault-Connell said.

She would know. At 16 years old, she contracted meningococcal B.

"I felt unwell in the morning -- I had some symptoms of fever and vomiting and headaches -- and literally by that night I was on life support."

She recovered, but only after having both legs amputated below the knee in order to stem the spread of deadly septicaemia.

When Should I Seek Medical Help?

Willie B. Thomas
A fever that won't go down with paracetamol or ibuprofen, a sensitivity to light and cold hands and feet can all be signs of meningococcal.

Another problem with treating meningococcal is that many of the symptoms look a lot like other common ailments, including the common cold and flu.

For many people, the disease brings to mind the distinctive red or purple rash which first appear as tiny red or brown pin prick marks, but Ault-Connell warns that, by the time the rash appears, it may be too late -- and there's a chance there won't be any rash at all.

"By then, it's actually a medical emergency and you must seek treatment right away. We're literally talking a matter of hours with meningococcal disease."

So what should you be looking out for -- and when should you seek medical help?

The first symptoms to appear are often a fever, vomiting and headaches, but there are some other, more distinctive warning signs.

"In babies, there may be irritability, there may be drowsiness, vomiting, a high pitched moan or a scream and that really strong fever," Ault-Connell said.

Some babies also develop a bulge on the soft spot on the top of their head.

Children and adults should also watch out for pain in their joints, a sensitivity to light and cold hands and feet.

"If there's a progression of any of these symptoms or if there's a fever that's just not responding to paracetamol or ibuprofen, then it is really important to go to the ED and rule out meningococcal disease," Ault-Connell advised.

"Go with your gut instinct. If you believe something is wrong and you or your child is just not feeling like themselves, go and get them checked out."

Meningococcal And Meningitis: Is There A Difference?

Yes, but they are related.

Meningitis occurs when a person's brain and spinal cord membranes become inflamed, which can happen for several reasons -- a meningococcal infection being the most serious one.

But there is another, more deadly, way for the meningococcus bacteria to invade the body -- through the blood.

When meningococcus enter the bloodstream, they multiply uncontrollably, damaging the walls of the blood vessels and causing bleeding into the skin (which is what causes the distinctive rash).

This is called meningococcal septicaemia, and it can kill within hours and leave its victims with severe scarring, skin grafts and amputation of fingers, toes, arms or legs.

Should I Get Vaccinated?

There are highly effectively vaccines available for all the major strains of meningococcal -- but just because you've had one, it doesn't mean you'll be protected against the others.

A vaccine for meningococcal C is available free under the National Immunisation Plan, and this year a number of state governments started providing a combined vaccine for four types of the infection -- including the deadly W strain -- to school students, at a cost of millions of dollars a year.

High schoolers aged 15 to 19 in NSW, Queensland, Tasmania, Victoria or WA will get able to get the jab for free at school or at their family GP or health clinic.

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The Director of Meningococcal Australia, Eliza Ault-Connell, wants free vaccines for meningococcal W and B rolled out nationwide.

"This is because teens are actually most likely to carry the bacteria," Ault-Connell explained.

"The hope is that by vaccinating the teen, the teen themselves is protected but it also prevents the carriage within our community -- it's called herd immunity."

But for adult Australians and those other states, if you want the vaccine you'll have to go to your GP and request it -- and it doesn't come cheap, costing up to $100.

The vaccine for the second most common strain, meninogcoccal B, is even more pricey, at between $120 and $150 per jab, with up to four doses required.

But advocacy body Meningococcal Australia is calling for the immunisation program to be extended to include the meningococcal B vaccine and rolled out nationwide.

"We've seen other governments overseas introduce meningococcal B vaccine to babies and children and in Australia we really should be doing the same thing," Ault-Connell said.

"We consider ourselves a lucky country, but there are still families that can't afford to go out and get this vaccine. It's a safe and effective vaccine.

"We can easily prevent meningococcal disease in Australia."

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