When my children were born and once the doctors assured me that they were healthy, I became quite obsessed with the fear that they suffered from meningitis, perhaps because as a child I lived closely its effects on a cousin of mine. So every time they had snot and fever, I insisted to their pediatrician: "Are you sure it's just a cold?"
Luckily (and I say this with knowledge of the cause, because it is a lottery to have it), the two got rid of meningococcal disease. And despite the existing vaccines and medical advances, we are still hearing tragic cases of babies suffering from it.
Therefore, when I was invited to a seminar organized by the Spanish Association of Pediatrics (AEP) and Pfizer to know in detail the types of meningitis, forms of infection and new strategies for prevention of meningococcal disease, I could not resist. I hope the information is as useful for other parents as it is for me.
A rare but very serious disease
According to the AEP, meningitis affects between 400 and 600 people each year. Of these, 10 percent die, and about 30% suffer permanent sequelae that can affect the circulatory system (amputations) or neurological (paralysis, intellectual or communication deficiencies, deafness, blindness or psychological disorders).
It is an infection caused by meningococcus, a bacterium that frequently lives in the nose and throat of healthy people. It appears when the bacteria 'attacks' the meninges and they swell. These membranes are those that cover the entire central nervous system (brain and spinal cord), and the cerebrospinal fluid they contain.
But the different information about meningococcal disease sometimes causes more confusion than information and becomes a mixture of letters (A, B, C, W, Y ...), understandable for those of us who are not doctors or do not know about close.
Types of meningitis
As explained in the seminar by Dr. Federico Martinón, head of the Pediatrics Service of the University Clinical Hospital of Santiago de Compostela, there are 12 different serogroups of meningococcus, although those that most frequently cause meningitis in Spain are especially those of serogroups B and increasingly the W and Y.
The serogroup C meningococcus is now very rare, thanks to being included in the free vaccination calendar.
In Babies and more Vaccine calendar 2019: these are the noveltiesRisk groups
It is unknown why the bacteria cause serious infections in some children, especially meningitis and sepsis (very serious infection of the blood) and not in others. And in 99% of cases, the disease attacks healthy children and adolescents, who have not suffered previous illnesses.
And, although meningococcal disease can appear at any age, They are children under four years and adolescents aged 15 to 18, the most affected by the bacteria. The worst prognosis is for children under one year.
In Babies and more, they recommend vaccinating adolescents against meningococcal meningitis In addition, according to Dr. Federico Martinón, head of the Pediatrics Service of the University Clinical Hospital of Santiago de Compostela, it is estimated that Up to 25% of teenagers can carry the bacteria, without becoming active but it can spread.
Symptom
It is difficult to diagnose since it manifests itself at the same time as a cold in the upper respiratory tract, as explained by Dr. María Garcés-Sánchez, a pediatrician at the Nazareth Health Center in Valencia and a member of the Vaccine Advisory Committee (CAV) of the Spanish Association of Pediatrics (AEP).
But, he adds that in 12 hours it can evolve abruptly with fever, headache and stiff neck. It can also be accompanied by nausea, intense vomiting, difficulty tolerating light (photophobia), confusion and excessive tendency to sleep.
And cause a sepsis (generalized blood infection) that can end the life of an infant in just a few more hours.
In fact, between 5% and 20% of meningococcal diseases manifest as meningococcal sepsis, without inflammation of the meninges. The symptoms also begin abruptly with fever and appearance throughout the body of small violet-red spots (petechiae) that in minutes become bruises.
The AEP warns of the importance of going to the emergency room as quickly as any symptoms are observed.
How is it spread?
This bacterium is transmitted by respiratory route, through the droplets that are expelled when coughing or sneezing. Therefore, the most favorable environments for transmission are schools and families.
It also facilitates the development of the infection exposure to tobacco smoke, having recently suffered another disease or the exchange of saliva (kisses, sharing drinks, pacifiers ...).
The best prevention: vaccines
Both Dr. Martinón and Dr. Garcés insist on pointing out that although meningococcal disease is very serious, "There are vaccines for the five most frequent serogroups, and they can immunize virtually the entire population."
These are three types of vaccines:
- The meningococcal vaccine (C MenC) It is included in the official vaccination schedule. It is given in three doses: at 4 months, at 12 months and at 12 years.
In Babies and more The meningitis C vaccine: everything you need to know - The tetravalent vaccine (MenACWY), which protects against serogroups A, C, W and Y, is available in Spain under medical prescription in pharmacies since 2017.
The AEP recommends including it in the official calendar instead of the current MenC (also at 12 months and 12 years), as Castilla y León has already done, since January 2019.
The Canary Islands have announced that they will also follow suit and will vaccinate with the tetravalent before summer. In fact, Sonia Tamames, head of Epidemiology of the General Directorate of Public Health of the Junta de Castilla y León, has stated that "All the Communities will end up financing this vaccine due to the increase in cases of meningitis caused by the new strains". And he explains the decision of his community:
“We have replaced the vaccine against meningococcal meningitis C with the tetravalent vaccine against meningococcal meningitis ACWY in the 12 months and 12 years, respecting the common calendar, but adding additional protection. At age 12 because teenagers are more at risk of getting sick and they are generally the ones who transmit the disease. And at 12 months, because until indirect protection is not strong enough, the smallest are the most vulnerable and need to be protected directly. What we try with this measure is that the disease does not continue to increase. ”
Dr. María Garcés-Sánchez, a member of the Vaccine Advisory Committee (CAV) of the AEP, adds that the intention of pediatricians is that adolescents over 12 years of age can also get vaccinated and the recommendation that medical centers report the possibility that those over 14 years of age are immunized individually with MenACWY vaccines.
- The vaccine against meningococcus B ('Bexsero') It is recommended after two months of age. It is not included in the vaccination calendar of the Ministry of Health and is dispensed in pharmacies under medical prescription. Only the Canary Islands and Castilla y León have recently announced the inclusion in their public vaccination calendar.
In Babies and more Canary Islands, it will be the first autonomous community to finance the Bexsero vaccine against meningitis BSonia Tamames, head of Epidemiology of the General Directorate of Public Health of the Junta de Castilla y León, explains that it is difficult to quantify the evolution of the disease caused by this serogroup, since families are paying for this vaccine out of pocket (three doses of 106 euros) and bet because "All communities end up financing it since both this and the tetravalent have already shown their effectiveness in other countries, in outbreaks in the Netherlands or the United Kingdom".
But the AEP insists that it is necessary to include it.
Photos | iStock
