All the facts on meningococcal meningitis in wake of death of Stellenbosch student

Following the tragic and sudden death of a 19-year-old theology student at Stellenbosch University, which has left students and staff reeling, the Western Cape institution has confirmed that Chris Scheffer died of meningococcal meningitis, a rare and fast-progressing infection.

Scheffers’ body was discovered on Saturday, 2 August, in his room at Dagbreek student residence. His tragic death has prompted a swift public health response, raising questions about the disease, how it spreads, and what steps people can take to protect themselves.

Here’s what we know about the infection.

What is meningococcal meningitis?

According to the National Institute for Communicable Diseases (NICD), meningitis is a viral or bacterial disease which infects the thin protective membrane (meninges) that covers the brain and spinal cord. The swelling happens when bacteria or a virus infect the fluid surrounding the brain and spinal cord.

In Chris Scheffer’s case, he contracted a bacterial form of the disease, called meningococcal meningitis, which is caused by the bacterium Neisseria meningitidis. Meningococcal meningitis also infects the brain and spinal cord’s protective covering. It is life-threatening and requires immediate medical attention.

According to the World Health Organization (WHO), meningococcal disease has a high fatality rate — 10% to 15%. If left untreated, infections can lead to death or permanent disability, including brain damage, hearing loss and limb amputation.

How is it spread?

Meningococcal meningitis lives in the nose and throat, where it is spread through respiratory droplets. This is usually through coughing, sneezing, kissing or sharing utensils and drinks.

Close and prolonged contact is usually needed for transmission. NICD says the bacteria can live harmlessly in the nose or throat of healthy individuals, known as “carriers”, who can still spread it.

Stellenbosch University said that because the strain of meningitis Scheffers died from was considered particularly serious, the institution had activated its Campus Health Services protocols in line with Western Cape Department of Health guidance. It was working closely with the provincial government to ensure all relevant protocols and preventive measures were adhered to.

Read more: The silent epidemic: Mpox’s resurgence in Africa calls for urgent global health action

What to look out for

Meningococcal meningitis can manifest itself in flu-like symptoms at first, but then rapidly progresses, and if left untreated, can result in severe illness and even death.

Early warning signs:

• Sudden high fever.
• Severe headache.
• Stiff neck.
• Nausea or vomiting.
• Sensitivity to light (photophobia).
• Cold hands and feet.
• Muscle or joint pain.

Advanced symptoms:

• Seizures.
• Drowsiness or confusion.
• Rapid breathing.
• Pale or mottled skin.
• A red or purple rash that does not fade under pressure.

According to the NICD, symptoms in infants and young children can be more difficult to detect, but key things to look out for include:

• Fever with cold hands and feet.
• High-pitched moaning.
• Blank staring.
• Inactivity.
• Drowsiness.
• Poor feeding.
• Inactivity.

How is it treated?

Immediate medical attention is critical if meningococcal meningitis is contracted, which is why Stellenbosch University announced that it had already begun detailed contact tracing of people who had been in close contact with Scheffers in the previous 10 days.

The university said that detailed contact tracing of people who were in close contact with Mr Scheffers over the past ten days is underway so that chemoprophylaxis (an antibiotic as preventative measure) can be provided within the next 24 hours to reduce risk of infection. The antibiotics can be in the form of either a single dose orally or intramuscularly, or an oral dose over two days.

However, the NICD recommends that if a person presents with symptoms, a doctor or ambulance should be called, or the person should immediately be transported to the nearest hospital or clinic.

“Persons with meningitis will usually be hospitalised. Intravenous antibiotics are usually given to all meningitis sufferers while waiting for confirmation of the diagnosis. Bacterial meningitis is usually treated for three to seven days with intravenous antibiotics,” said the NICD.

Can it be prevented?

Yes, vaccines are the most effective form of prevention.

While the meningococcal vaccine is not part of South Africa’s public immunisation schedule, it is available in the private sector and often recommended for:

• University students/military personnel living in communal housing.
• Laboratory workers.
• Travellers to countries where outbreaks are common.
• Individuals with weakened immune systems.

Other ways to prevent contracting the infection include practising good hygiene, not sharing drinks, avoiding close contact if sick, and covering your mouth when coughing. DM

This article was updated with an amendment on 14 August to clarify that the university of Stellenbosch said detailed contact tracing of people who were in close contact with Mr Scheffers over the past ten days is underway so that chemoprophylaxis (an antibiotic as preventative measure) can be provided within the next 24 hours to reduce risk of infection.