Meningococcal Meningitis: a devastating illness

World Meningitis Day is on 24 April and the theme for 2020 is #DefeatMeningitis.

The aim of this day is to raise awareness about Meningococcal Meningitis in particular, a disease that can be devastating, with high fatality and a life-changing permanent impact on survivors, even when adequate treatment is provided. (1a+f)

Meningococcal disease is an infection of the lining of the brain and spinal cord also called Meningitis (5a). Meningitis is an extremely serious disease and can be fatal (4a). It can also cause serious complications especially permanent neurologic damage (2a).

Meningitis

The highest incidence of Meningococcal disease is in infants younger than 12 months, but a second, lower peak occurs in adolescence (3a). Vaccines are therefore highly recommended in preventing bacterial Meningococcal disease (3b). Ideally, all South Africans should be protected against this disease, even though the risk of acquiring it is low (1j).

“The best way to protect your family is to make sure they are vaccinated,” says Dr Nasiha Soofie, Medical Head for Sanofi Pasteur Vaccines in South Africa. “The Meningococcal conjugate vaccine protects against four types of Meningococcal bacteria and is recommended for all infants and children. It provides your loved ones with optimal protection against this devastating disease.”

Risk factors for acquisition of carriage (which is a prerequisite for disease) include passive smoking, intimate personal contact (kissing), pub attendance, overcrowding, the attendance of mass gatherings and previous antibiotic use (1i, 5b).

“Meningococcal Meningitis can end the life of a child in less than 24 hours,” says Dr Soofie. “Up to 20% of survivors, at any age, are at risk of severe, permanent complications like deafness, amputation and mental disorders. That’s why prevention through vaccination is vital.”

Invasive Meningococcal Disease (IMD) in South Africa – the facts

  • Meningococcal disease is endemic in South Africa with sporadic cases occurring throughout the year, usually increasing from May to October (1i).
  • Average incidence in the population over the past decade is 1 per 100,000, with a peak of 8 per 100,000 people in infants (1i).
  • Up to 25 % of teenagers (15 – 19 years) carry and transmit the disease (1b).
  • Paediatric patients, adolescents and adults (up to age 55) can be vaccinated against IMD (3b).
  • Although the incidence is currently low in South Africa, the consequence of acquiring the disease can be devastating with high morbidity and mortality despite adequate treatment (1a+f).

Symptoms of Meningitis

The most common symptoms of meningitis include: (5c)

  • Stiff neck
  • High fever
  • Sensitivity to light
  • Confusion
  • Headaches
  • Vomiting

How is the vaccination given?

It’s recommended that infants 9 months through to 23 months should be given a two-dose primary vaccination series with a dosing interval of 12 weeks, while healthy children 2 years and older require just a single primary dose (1g). A booster dose should be given if the Meningococcal vaccine has been given more than five years previously (1e).

Meningitis

For adolescents and young adults, vaccination should be considered before they enter their first year of university or college, especially if they will be staying in a residence hall or hostel (1h).

“No one should ever have to see their child, sibling, friend or classmate suffer or die from a disease that is vaccine-preventable,” says Dr Soofie.

Protect your children and prevent the spread of meningitis both in schools and your community. Speak to your doctor of pharmacist for further information about optimal protection against this devastating disease.

References:

1. Meiring S, Hussey G, Jeena P, et al. Recommendations for the use of meningococcal vaccines in South Africa. South Afr J Infect Dis 2017;32(3):82-86.
2. Batista RS, Gomes AP, Dutra JL, et al. Meningococcal disease, a clinical and epidemiological review. Asian Pacific Journal of Tropical Medicine 2017;10(11):1019-1029.
3. American Academy of Pediatrics Committee on Infectious Diseases. Prevention and control of meningococcal disease: recommendations for use of meningococcal vaccines in pediatric patients. Pediatrics. 2005;116(2):496-505.
4. Centers for Disease Control and Prevention (CDC) Meningococcal Disease (Neisseria meningitidis) [Online; March 10, 2017] Available at https://wwwnc.cdc.gov/travel/diseases/meningococcal-disease Last accessed December 2019. 5.
5. World Health Organization (WHO). Meningococcal meningitis: Fact sheet. 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/meningococcal-meningitis

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