The bacterium Neisseria meningitides (meningococcus) can cause acute meningitis/septicaemia infection. Of the 13 capsular serotypes of this bacterium that have been identified, six of these (A, B, C, W135, X, and Y) account for most disease cases worldwide. Group B is the most predominant cause of infection currently in the UK. Other serogroups including A and the less common W135 strain can cause serious epidemics which occur predominantly in the African region described as the meningitis belt from Senegal in the west across to Ethiopia in the east. These serotypes have also been responsible for outbreaks in Saudi Arabia. Meningitis infection can occur at any age and children under 5 years and teenagers are most frequently affected. Bacterial transmission occurs by sneezing, coughing or direct contact with respiratory secretions. It is estimated that the bacteria are found in the nasal passages of healthy individuals with around 25% of adolescents and 5-11% of adults carrying the bacteria.
Recommendations for Travellers
Respiratory infections are often difficult to prevent but following basic personal hygiene etiquette when coughing and sneezing can help. Avoiding overcrowded areas such as busy markets and local transport may also reduce risk of exposure but may not always be practical.
Vaccination to protect travellers against multiple meningococcal strains: A, C, W-135 and Y is available. Nimenrix manufactured by GSK is the vaccine product currently available in the clinic. This is different to both the C strain vaccine included in the UK childhood vaccination programme which only protect against type C and the newly introduced B strain vaccine. Individuals should consider being vaccinated with Nimenrix vaccine if they are travelling to a country where meningococcal meningitis is present and where their stay may be prolonged or they are involved in activities which may increase the risk of exposure to the disease, for example, working and living closely with the local population. Specific vaccination requirements for travellers attending Hajj and/or Umrah pilgrimage are published by the Saudi Ministry of Health and certificates of vaccination are a visa requirement for these travellers. As with all vaccines the clinical staff will advise during the travel consultation on all aspects of the procedure including vaccine dose schedule, contraindications to vaccination, any possible interactions with other vaccines or medications, the range of possible adverse effects from the specific vaccine and any queries. Written product information to retain for reference is also provided.