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Epidemic Control Toolkit
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Meningococcal meningitis

Meningococcal meningitis

Last update: 2023-06-13

Key facts

Transmission: Airborne and direct contact

  • When infected people cough, sneeze, blow their nose or spit, they spread small particles through the air, which are then breathed in by other people
  • Direct contact (for example, through kissing, sharing cups or eating utensils) with infected saliva or nose mucous

Most vulnerable to severe disease

  • Unvaccinated infants, teenagers and young adults 
  • People gathered in large groups (for example, at community or religious festivals)
  • People living with other illnesses such as sickle cell anaemia or HIV/AIDS 

Vulnerable to contracting the disease

  • Unvaccinated people
  • People living in cramped and crowded conditions (for example displaced populations)


  • High fever (usually)
  • Headache (usually)
  • Stiff neck (usually)
  • Nausea and vomiting (sometimes)
  • Sensitivity to light (sometimes)
  • Confusion (sometimes)

Symptoms in newborns and infants

(** small babies may not show the same symptoms as older children and adults** )

  • Bulging fontanelle (soft spot) on the head
  • Inactivity
  • Sleepiness/difficulty waking
  • Crying and irritability
  • Vomiting
  • Refusing to eat
  • Rapid breathing
  • Blotchy skin, turning pale and then blue
  • Stiff, jerky movements
  • Rash

What can you do to prevent and control an epidemic?

Monitoring the community and identifying sick people 

  • Identify and ensure sick people isolate before they spread the disease to others 

Treatment and management

  • Refer those with suspected meningitis to health facilities 
  • Support contact tracing and follow-up of close contacts for chemoprophylaxis (antibiotics)
  • Provide psychosocial support to the sick person and their family members

Safe shelters and spaces

  • Reduce overcrowding and improve ventilation in living shelters, workplaces and schools, if possible

Hand and respiratory hygiene

  • Promote good hand hygiene (handwashing with soap) 
    • BEFORE: preparing food; eating; feeding a child; treating wounds; or caring for sick people
    • AFTER: using the toilet or cleaning a baby; touching garbage or waste; touching or feeding animals; blowing nose, coughing or sneezing; treating wounds; or caring for sick people
  • Promote respiratory hygiene and coughing etiquette (cover cough or sneeze using a sleeve or tissue, wash hands after coughing or sneezing, do not spit onto the ground or in public)

Social mobilization and health promotion

  • Find out the specific advice being given by health and other relevant authorities 
    • Promote recommended health practices (such as routine vaccination, social distancing, separation of healthy people and sick people, etc.)
  • Model following this advice and inform community members of current health practice advice 
  • Offer support and encouragement to follow the advice  
    • Try to gain understanding about if and why health practice advice is not being followed  
    • With the guidance of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices 


  • Promote routine vaccination programmes for children
  • Support mass vaccination campaigns


Mapping and community assessment

  • Make a map of the community.
  • Mark the following information on the map:
    • How many people have fallen sick with meningitis? Where?
    • How many people have died? Where? When?
    • Who and where are the vulnerable people?
    • Where are the health facilities? (include traditional healers)
  • Record the following information on the back of the map:
    • When did people start to fall sick with meningitis? 
    • How many people live in the affected community? 
      • How many are children under five years? 
      • How many teenagers and young adults?
      • Is HIV/AIDS prevalent among the population?
    • Are most people in the community vaccinated against meningitis? 
      • Is there a vaccination campaign planned?
  • How many close contacts do people with meningitis have? 
    • Have there been large gatherings recently?
    • Are people with meningitis living in cramped or overcrowded conditions?
    • Are contacts showing symptoms of meningitis?
  • How common is it for people to live together in crowded spaces? Is there ventilation and fresh air in homes, schools and workplaces? 
  • Are children badly affected by meningitis? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected? 
  • What are the community’s habits, practices and beliefs about vaccinations? Are there societal, cultural or religious beliefs that prevent people from getting vaccinated? 
  • What are the community’s habits, practices and beliefs about caring for and feeding sick people? Consider any differences in roles and responsibilities between men and women.
    • When babies and infants are sick, do women continue to breastfeed them?
  • Is a social mobilization or health promotion programme in place?
  • Which sources do people use/trust the most for information?
    • Are there rumours or misinformation about measles or vaccines? What are the rumours?