The Western Cape department of health and wellness is closely monitoring a small but notable increase in meningococcal meningitis cases among adolescents and young adults, even as infants continue to bear the greatest burden of the disease.
Between January 1 and February 22, the province recorded 11 confirmed cases of meningococcal disease, including one death. Health officials say the cases are sporadic and do not constitute an outbreak.
Of the confirmed infections, eight were recorded in the Cape Town metro, two in the Cape Winelands and one in the Overberg district. The majority of cases were reported in children under the age of one.
Meningococcal meningitis is caused by the bacterium Neisseria meningitidis. Though uncommon, the disease is severe and can progress rapidly. It spreads through respiratory droplets during close contact such as speaking, coughing or sneezing, making settings like schools, crèches, hostels and student residences particularly vulnerable.
According to the National Institute for Communicable Diseases (NICD), meningococcal disease is endemic in South Africa, occurring throughout the year with a seasonal peak between June and October.
Forty to 60% of all cases occur in children younger than five years, and among those, most are younger than two years. But we also see it in older children and adults.
— Helena Rabie, professor of paediatrics and child health at Tygerberg Hospital and Stellenbosch University
Helena Rabie, professor of paediatrics and child health at Tygerberg Hospital and Stellenbosch University, said infants and toddlers remain the most vulnerable group.
“Forty to 60% of all cases occur in children younger than five years, and among those, most are younger than two years. But we also see it in older children and adults. In fact, we are seeing a small increase in cases in adolescents and young adults between the ages of 15 and 25 years,” Rabie said.
She noted that some individuals can carry the bacteria in their nose and the back of their throat without becoming ill but can still transmit the infection to others.
Infants and young children are particularly susceptible because of their immature immune systems. Certain bacteria, including meningococcus and pneumococcus, are adept at evading early immune responses.
Early symptoms may resemble common childhood illnesses, including fever, vomiting and irritability. However, Rabie warned that parents should be alert to a rash that does not fade when pressed, known as petechiae, though the rash may sometimes be absent or appear as a red blotchy rash.
Other warning signs:
- Fever or abnormally low temperature in young infants
- Poor feeding
- Unusual sleepiness or decreased responsiveness
- Pale or mottled skin
- Cold hands and feet
- Rapid breathing
- A weak or high-pitched cry
- A bulging fontanelle
- Floppiness
“Parents should seek immediate medical attention if their child develops these symptoms,” said department spokesperson Shimoney Regter.
Rabie said several serogroups circulate in South Africa. Type B accounts for about 30–40% of cases, while types C, W and Y make up most of the remainder. The pattern has remained relatively stable over time.
Vaccines are available for certain strains. A vaccine targeting C, W and Y strains can be used in older children, and a newly licensed vaccine can be administered from a few weeks of age. However, meningococcal vaccination is not part of South Africa’s routine national immunisation programme.
Regter confirmed that registered meningococcal vaccines are available in the country and are recommended for people at higher risk. They are offered at tertiary hospitals to identified high-risk individuals or are accessible privately with a doctor’s prescription.
Meningococcal disease is a notifiable medical condition, meaning all suspected and confirmed cases must be reported. Close contacts are identified and provided with prophylactic antibiotics to prevent further spread.
The department said it continues to monitor surveillance data to detect trends, clusters or geographic concentrations that may require targeted vaccination or outreach interventions.
Would you like to comment on this article?
Sign up (it's quick and free) or sign in now.
Please read our Comment Policy before commenting.