Heart failure, kidney shutdown and widespread bleeding in the internal organs can occur. The mortality rate is between 25-50 percent. The meningitis, usually referred to as meningococcal meningitis to distinguish it from that caused by other organisms can also be extremely serious, and is most commonly seen in young children, who have not yet developed any immunity to the organisms, although it is also a common cause of meningitis in adults. The early symptoms are usually fever, headache, stiff neck, confusion and lethargy. Other members of the household of someone who develops invasive N. meningitidis infection should be treated prophylactically with an antibiotic to eliminate bacteria they may be carrying.
Rifampin is the antibiotic now most commonly used.
School classmates, staff and other close contacts of the infected person should also be treated. A partially effective vaccine against N. meningitidis has been developed and improved vaccines are now undergoing trials. Universal immunization is not presently recommended, but the American College Health Association recommends it for all college students, and certain other suceptible groups are also given the vaccine. It is recommended for travellers to sub-Saharan Africa where invasive disease is more common, as well as for people who have had to have their spleen removed. The question that our writer mentions about the sick person having been to a foreign country may have come about because of confusion between Waterhouse-Friderichsen syndrome and blackwater fever, a severe and often deadly complication of malaria.