Meningitis B Outbreak

Reading the headlines about the superspreader event at Club Chemistry, it is understandable that many people feel anxious about such an outbreak. In Scotland however, the risk does remain low; cases so far are within expected levels and there is no indication any cases in Scotland are linked to the Kent outbreak. The situation remains under review, but currently Public Health Scotland does not advise of any increased risk to people in Scotland and there are no recommended changes to the vaccination program or advice.

Below is some useful information on meningitis and the vaccination program.

Vaccine stocks and getting you or your children vaccinated
MenB vaccine is currently (unsurprisingly) not available. We are endeavouring to source some.

Whilst there is no need for urgency there is a reasonable case to get young adults aged between 15 and 24 vaccinated.

We would recommend that a primary course or booster is given close to the highest risk time for the young adult as immunity wains quite quickly (1 to 3 years). Ideally it is given just before going to university or an equivalent environment where young adults are living in close proximity ie university, military academy, boarding school etc.

Young adults born after 2015 are likely to have had a primary course and will just need a booster. Other young adults will need a course of 2 injections.

We will be happy to provide these once vaccines are available again. Please email us on [email protected] and we will put you on a waiting list.

We could consider vaccinating other at risk groups such as:

• Infants <1 year if they are not in the UK vaccine programme
• Adolescents / young adults 15 to 24
• Immunocompromised (complement deficiency, asplenia) not in the UK program
• Household contacts of a case if advised by public health
• Crowded living environments such as boarding schools, military camps, refugee camps.

What is it?
Meningitis B is a serious bacterial infection that can lead to life-threatening complications such as meningitis and sepsis. Despite its severity, the bacteria responsible for this condition are surprisingly common, and often harmless. Many people carry meningitis B bacteria in their bodies without ever becoming ill. These bacteria typically live in the nose and throat without causing any symptoms. Around 10% of the UK population carries the bacteria at any given time; among teenagers and young adults, this rises to approximately 25%. In most cases, the bacteria coexist harmlessly with the host and do not lead to disease.

Serious illness occurs only in rare situations. For meningitis or sepsis to develop, the bacteria must cross protective barriers in the body, such as the lining of the nose, and enter the bloodstream or surrounding tissues. When this happens, the infection can rapidly become severe and requires urgent medical attention.

The reasons behind more severe outbreaks are not always clear, but several factors may play a role:

• Bacterial changes: Variations or mutations may make the bacteria more aggressive
• Human behaviour: Social interactions, crowding, or lifestyle patterns can influence spread
• Environmental factors: Seasonal changes or local conditions may affect transmission

Often, it is a combination of these factors rather than a single cause. Early recognition and prompt medical care remain essential in reducing the risk of serious complications.

Understanding the Vaccines: MenB vs MenACWY
MenB vaccine
• Protects against meningococcal group B, responsible for the majority of UK cases
• Protection provided by the vaccine reduces so only lasts between 1 to 5 years
• Introduced into the UK infant vaccine programme in late 2015
• Given at:

• 8 weeks
• 12 weeks
• 1 year booster

• Not routinely offered to teenagers or adults in the NHS programme

Most adults and older children (born before 2015) have not received a primary MenB vaccination course.

MenACWY vaccine
• Protects against groups A, C, W and Y
• Routinely offered to:

• Teenagers (age 14)
• University entrants (catch-up up to age 25)

• Helps reduce carriage and transmission, unlike MenB giving some degree of “herd immunity”
• The protective effect of the vaccine lasts around 5 years
• Meningitis due to these strains does occur but the number of cases has been reduced to exceptionally low levels as a result of the vaccination program.

Who Should Consider Vaccination Now?
Infants and young children
• Should follow the routine NHS MenB schedule
• Ensure all doses are up to date

Teenagers and university students
• Should have MenACWY vaccination (essentially preferably before university)
• Consider private MenB vaccination, especially in:

• Shared accommodation
• Outbreak settings
• High-risk of exposure

Adults under the age of 25 (especially born before 2015)
• Probably not vaccinated against MenB
• Consider vaccination if:

• Living in close-contact settings
• Healthcare workers or carers
• Exposed during outbreaks

By Dr David Richardson, Director and Lead GP, Edinburgh GP