March 16, 2026

expert reaction to meningitis outbreak in Kent

Prof Paul Hunter, Professor in Medicine, The Norwich School of Medicine, University of East Anglia, said:

“Meningitis is an infection of the lining of the brain (the meninges). There are several different bacterial and viral and one fungal causes that are associated with meningitis. However, from what has been reported in the media the current outbreak appears to be due to meningococcal disease.

“Invasive meningococcal disease is a very serious infection that causes meningitis and septicaemia. In the year 2025/24 there were 378 confirmed cases of invasive meningococcal disease. The term invasive means an infection that spreads through the body to normally sterile sites such as the blood stream (septicaemia) or brain. Of these 378 cases 31 (8.2%) died  (https://www.gov.uk/government/publications/meningococcal-disease-laboratory-confirmed-cases-in-england-2024-to-2025/invasive-meningococcal-disease-in-england-annual-laboratory-confirmed-reports-for-epidemiological-year-2024-to-2025). In people who survive about 10 to 20% will suffer a long term disability such as deafness, loss of limbs or brain damage (https://pmc.ncbi.nlm.nih.gov/articles/PMC6249177).

“The greatest risk of meningococcal infections are in children under 1 years old (5-10/100,000 children). In other age groups the risk is about 1-2 per 100,000 people/year. There is, however and increased risk in young people aged 15 to 19 year old. This increased risk is often associated with the person moving away from home especially when living in crowded conditions.

“About 10% of people carry the bacteria at any one time and this is even higher in adolescents (https://pmc.ncbi.nlm.nih.gov/articles/PMC3373034/).  The infection is spread between people during close contact such as living in the same household or whilst kissing (mouth to mouth).  

“There are several different types (groups) of meningococcus. About 80% of invasive infections are now due to group B meningococcus. The other groups such as group C has become much less common in recent years due to vaccination. Group A is more associated with infections in Africa in the so called “meningitis belt”

“There are currently 2 main vaccines used in the UK. The 4CMenB vaccine is given at 8, 12 and 52 weeks of age. This is primarily against group B meningococci, though there is some protection against some other groups (https://academic.oup.com/cid/article/73/7/e1661/5897488). However, not all Group B strains are coved by the 4CMenB vaccine. The other vaccine is the MenACWY which is given at around 14 years of age. In the UK we do not currently give a booster group B vaccine to adolescents, though some countries do (https://pmc.ncbi.nlm.nih.gov/articles/PMC6422514/). The reason not to offer a group B vaccine is based on cost benefit studies. This vaccine does not stop transmission whereas the MenACWY vaccine does reduce transmission of the groups included.

“When there are cases of invasive meningococcal disease and especially when there are multiple related cases public health teams follow UKHSA guidance (https://www.gov.uk/government/publications/meningococcal-disease-guidance-on-public-health-management). After a single case antibiotics may be offered to close contacts. Close contact is defined as prolonged close contact with the case in a household type setting during the 7 days before onset of illness. Antibiotics may also be offered to someone who “had transient close contact with a case only if they have been directly exposed to large particle droplets or secretions from the respiratory tract of a case around the time of admission to hospital”.

“When we see multiple linked cases of invasive disease, antibiotic are given to a wider circle of contacts. If the infecting bacteria is a group other than B we would usually offer MenACWY to the same people offered antibiotics. If as is most usual the infection was a group B meningococcus, vaccination with a group B vaccine may be offered unless the data suggests that the infection would not be covered by the vaccine.

“The most important thing any friend or parent can do is realise the person may have this infection and seek medical help. Early treatment is vital, but diagnosis in the early hours of the illness can be very difficult. Early symptoms can be very mild but then deterioration can be extremely rapid leading to death within a few hours. Some of the warning signs include high fever, neck pain and stiffness, the light hurts their eyes, confusion and drowsiness and a particular skin rash that doesn’t blanch if  a glass is pressed onto the skin (https://www.meningitis.org/about-meningitis/bacterial-meningitis/meningococcal-meningitis/#symptoms). If worried contact NHS 111 for further advice (https://111.nhs.uk/) or seek immediate medical attention.”

Dr Zina Alfahl, School of Medicine, University of Galway and Applied Microbiology International One Health Advisory Group Member, said:

What is meningitis and how rare/common are outbreaks like this? What does ‘invasive’ mean?

“Meningitis is inflammation of the membranes that surround the brain and spinal cord. It can be caused by viruses or bacteria, but the most dangerous outbreaks are usually caused by the bacterium Neisseria meningitidis. When doctors say “invasive meningococcal disease”, they mean the bacteria have entered normally sterile parts of the body, like the bloodstream or the fluid around the brain. That can lead to meningitis or a severe blood infection called meningococcal sepsis. Overall the disease is rare in the UK, but when several linked cases appear in the same place — for example a university community — it becomes a serious public-health concern because the illness can progress very quickly.

How dangerous is a meningitis outbreak – what is the risk to those in the Kent area/ the UK?

“Meningococcal disease is dangerous because it can become life-threatening within hours if it isn’t treated quickly. However, it’s important to put risk in perspective. For the general public in Kent or across the UK, the overall risk remains very low. The people at highest risk are usually close contacts of cases — people living together, close friends, or those sharing social spaces with prolonged contact. So while this is a serious cluster that requires urgent investigation and control measures, it does not mean there is a widespread risk to the whole population.

Are students and young people at particularly high risk?

“Yes, teenagers and young adults are a recognised higher-risk group for meningococcal disease. That’s partly because many people in this age group carry the bacteria in the nose or throat without symptoms, and it spreads through close contact such as coughing, kissing, or sharing drinks. University environments — halls of residence, parties, and large social networks — create conditions where the bacteria can spread more easily. That’s why vaccination programmes and rapid public-health responses often focus on students and young adults when clusters occur.

What causes outbreaks of this nature?

“Outbreaks usually happen when a particular meningococcal strain enters a community where people are mixing closely and some individuals are susceptible. The bacteria are often carried harmlessly in the throat, especially among teenagers and young adults. Transmission occurs through respiratory droplets and close contact. So outbreaks are usually driven by a combination of factors: the characteristics of the strain itself, the level of immunity in the population, and environmental factors like crowded living or social settings where people mix intensively.

Can you vaccinate against meningitis and could vaccination rates be a possible factor in the outbreak?

“Yes, but it’s important to understand there isn’t just one meningitis vaccine. Different vaccines protect against different meningococcal groups, such as A, C, W, Y, and B. In the UK, adolescents are routinely offered the MenACWY vaccine, and infants receive the MenB vaccine. Whether vaccination rates played a role in this outbreak will depend on which strain is involved, which hasn’t yet been confirmed. Until that information is available, it would be premature to attribute the outbreak to vaccine uptake.

How effective are meningitis vaccines and how high is uptake? 

“The meningococcal vaccines used in the UK are highly effective, particularly the MenACWY vaccine given to teenagers. Uptake in adolescents is generally good — around 70–75% in recent school cohorts — although it hasn’t fully returned to pre-pandemic levels. Infant uptake of the MenB vaccine is even higher, typically above 85–90%. However, many current university students were born before the infant MenB programme began in 2015, which means some of them may never have been routinely offered that vaccine.

It’s reported that the current strain isn’t known yet – how will that be found and why is that information useful?

“The strain will be identified through laboratory testing of patient samples — usually blood or cerebrospinal fluid. Specialist reference laboratories can determine the serogroup of the bacteria and sequence its genome. That information is extremely useful because it tells public-health teams whether the cases are linked, which strain is circulating, and whether targeted vaccination or other interventions might help stop further spread.

What can people do to protect themselves from meningitis?

“The most important thing is recognising symptoms early and seeking medical help quickly. Early symptoms can look like flu — fever, headache, vomiting, muscle pain — but they can progress rapidly to severe illness. People should seek urgent medical advice if symptoms worsen or if there are warning signs such as neck stiffness, confusion, sensitivity to light, or a rash that doesn’t fade when pressed. It’s also important for students and young people to check they are up to date with recommended meningococcal vaccinations.

What will health authorities be doing to prevent further spread and/or deaths in an outbreak like this?

“Public-health teams will move very quickly in situations like this. They will identify and monitor close contacts of cases, provide preventive antibiotics where appropriate, and carry out detailed laboratory testing. They may also consider targeted vaccination depending on the strain involved. At the same time, they will work with the university and local healthcare providers to ensure people know the symptoms and know when to seek medical care.

Any other comments on the situation that you think it would be useful for journalists to know for their reporting.

“One important point is to keep the risk in proportion. Meningococcal disease is serious and can progress rapidly, but it is still rare overall, and outbreaks are usually limited to specific networks or communities. It’s also important not to jump to conclusions about vaccines until the strain is confirmed. Different meningococcal groups are covered by different vaccines. Clear reporting should focus on symptom awareness, rapid treatment, and the targeted public-health response that is already underway.”

Dr Simon Clarke, Associate Professor of Cellular Microbiology, University of Reading, said:

“Meningitis is an inflammation of the membranes that protect the brain and spinal cord, and it can be caused by a range of organisms, most commonly bacteria and viruses. Bacterial meningitis, including meningococcal disease, is the more serious form, but it remains uncommon, and with rapid treatment most people recover fully. The bacteria that cause meningococcal meningitis are often carried harmlessly in the nose and throat; around 10% of the general population carry them without ever becoming ill. In adolescents and young adults, carriage can be higher, with large UK studies showing rates between 7% and 18%. 

“Transmission requires close, prolonged contact such as coughing, sneezing or kissing, and even among carriers only a very small proportion ever develop invasive disease. Symptoms can appear suddenly and may resemble flu at first, but severe headache, fever, neck stiffness, confusion, or a rash that doesn’t fade under pressure are important warning signs. With prompt medical care, outcomes are generally good and long‑term complications are far less common than they once were. 

“Vaccination remains the best protection. The MenACWY and MenB vaccines used in the UK are safe, well‑tested, and available free to eligible UK and international students.”

Prof Andrew Preston, Professor of Microbial Pathogenicity at University of Bath, said:

“Meningitis is inflammation of the meninges, the protective tissue layers around the brain and CNS. There can be several causes, including viral and bacterial infection. It is an extremely dangerous condition.

“UKHSA have reported the outbreak is likely to be meningococcal, so Neisseria meningitidis bacteria. These bacteria inhabit the nasopharynx and in the vast majority of cases colonise that niche without causing any issues. In a very small number of cases, the bacteria can gain access to the blood, where the pathogenic Neisseria meningitidis can survive and multiply. This is sepsis, another devastating disease. From there, bacteria can cross the blood brain barrier to access the CNS, leading to meningitis. The term invasive denotes this moving from the nasopharynx to the blood and/or CNS.

“NM type b was the most dangerous of the NM types, but disease can also be cased by other types (ACWY)

“Meningitis outbreaks used to be regular, although small clusters of cases, particularly among University students in halls at the start of the academic year. The bacteria are transmitted by respiratory droplets, between people in close contact.

“In the UK, vaccination against type b is administered to babies, as of July last year at 8 and 12 weeks with a 1 year booster. As many of the cases among adolescents tended to be due to the other types, an ACWY vaccination is given to years 9 or 10 (13-14 years old).

“The vaccines are highly effective at protecting against invasive disease. Unusually, they also reduce carriage as they generate immune responses that reach the nasopharynx, and cases decreased very significantly on implementation of the ACWY vaccine.

“Uptake of the ACWY vaccine among adolescents is around 73%, so there are a lot of unvaccinated students given the size of the student cohort. 

“So, an outbreak of this size and speed is very unusual, and of great concern.

“It is important to characterise the cause of the outbreak. A sudden change in disease pattern could indicate something like a new strain with different behaviours. It will be important to ascertain the vaccination status of those affected.

“Fortunately, antibiotic resistance isn’t (yet) a major feature of these bacteria, so prophylactic antibiotics can be given to close contacts of cases, as is being done in Kent. There will also be an opportunity for those who did not receive their adolescent vaccine the chance to have a catch up jab, but the immunity from that will take a little while to develop.”

Dr Michael Head, Senior Research Fellow in Global Health, University of Southampton, said:

“There is a high level of ‘carriage’ of the bug that typically cause meningitis outbreaks, with maybe 20% of the population harmlessly carrying the bacteria in their nose or throat. If individuals encounter a strain that they do not have sufficient immunity against, then infection is possible. Carriage rates are usually highest in teenagers and younger adults, hence why new populations mixing at university can cause outbreaks. And as we have seen, the disease can be severe and occasionally fatal. Vaccination has been the key tool to reduce the numbers of meningitis cases and deaths.”

Prof Keith Neal, Retired Professor of the Epidemiology of Infectious Disease, University of Nottingham, said:

“I dealt with many university cases and a few community outbreaks in the past when meningitis was more common. This current outbreak is unusual.

“‘Invasive’ means the germ has invaded into the blood stream or brain linings from the throat.

“Risk to those in the Kent area is low although this is a community outbreak so there is a small risk; I suspect in the older teenage and student groups. Under 5s are most at risk to becoming seriously unwell with meningitis but teenagers and students are at a higher risk due to social mixing.

“There are two vaccines, MenB which is part of the childhood schedule and ACYW135 which is given to teenagers and there is quite good uptake of these vaccines in the UK.

“Determining the strain will help tell us what vaccine might be useful; a PCR test will be able to do this.

“There may a slightly different strain of meningitis which can spread between people. Most people who acquire the bacteria develop immunity and a very low percentage get ill. We may not be able to pinpoint the exact origin or this outbreak.

“People should look out for the early symptoms and health authorities will be making those at higher risk of infection aware of what they are, provide antibiotics to close contacts and may vaccinate where appropriate.

Declared interests

Prof Andrew Preston:I have received funding for research from vaccine companies, although not related to meningococcus or meningococcal vaccines.

Dr Michael Head: “No COI to declare”

Prof Keith Neal: “No COI”

For all other experts, no reply to our request for DOIs was received.