Meningitis: what is it, types and vaccines

The meningitis It is a rare disease that evolves very rapidly and has very serious consequences: 10% of cases are fatal and 30% have very serious consequences.

For years, in Spain, the meningitis vaccine to all children compared to the most common types of meningitis. Currently, in all regional vaccination schedules and in the only lifetime vaccination schedule, the Ministry of Health includes the following vaccines:

• Haemophilus Influenzae type B (HiB) at 2, 4 and 11 months.
• Meningitis C at 4 and 12 months with a booster dose at 12 years.
• Pneumococcal at 2, 4 and 11 months.

Meningoco, W, Y, A, C … what a jumble of letters!

In addition to the three types mentioned, there are other types of meningitis, previously rare but equally dangerous, such as meningitis caused by meningoco w where the Meningococcal AND that have increased their incidence and have begun to talk more in the media recently, following the Autonomous Region of Castile and León has included meningococcal vaccine A, C, W and Y (MenACWY) in your calendar of vaccination of children for 2019, 12 months and 12 years.
Indeed, the Spanish Association of Pediatrics (AEP) has requested that this vaccine be included in immunization schedules for children from all Autonomous Communities.

Moreover, we have all heard of another type of meningococcal B meningitis, for which there is also a vaccine (the famous Bexsero) that are not covered by the child immunization schedules, even if pediatricians recommend it. This vaccine can be purchased at the pharmacy with a pediatrician's prescription to give to the child at the health center. Its price is high (106 € / dose and depending on the age that is set for the first time are 2 or 3 doses) and not everyone can pay, which generates a situation of inequality . Nearly a month ago, the Canary Islands announced that this vaccine would be included in their immunization schedule for children and was recently also announced by Castilla y León.

In this context of debate, I attended a briefing seminar a few weeks ago on meningitis, organized by ANIS and Pfizer Laboratories, during which different experts explained how it was based. meningitis what types of meningitis There is how it is contagious and how one can avoid it.

How is meningitis born?

Meningitis is an infection caused by meningococcus, a bacteria that, under normal conditions, coexists with other living organisms in the nose and throat of healthy people.

Meningitis occurs when the bacterium is mutating (which occurs very rarely) and becomes aggressive, attacking and inflaming the meninges (membranes that cover the brain and spinal cord).

Although we know some external factors that may facilitate the development of infection, such as exposure to tobacco smoke, viral infections or immunity defects, In 90% of cases of meningitis, no factor can be identified a priori.

Diagnosis of menignitis

Meningitis has a very rapid evolution. At first, it is difficult to diagnose because, according to Dr. María Garcés-Sánchez, a pediatrician at the Nazaret Health Center in Valencia and a member of the Vaccine Advisory Committee (CAV) of the Spanish Association of Pediatrics (AEP), "this begins with a catarrh on the motorways, with mucus, cough, fever … But in a few hours, it evolves brutally, causing a high fever, headaches and stiffness of the neck ".

It can also cause nausea, severe vomiting, difficulty tolerating light (photophobia), confusion, and an excessive tendency to drowsiness. Early diagnosis is fundamental for the evolution, which is why it is necessary to go to the emergency room before the minimum suspicion.

The infection mainly affects children under four years, especially babies (which are the most accusing consequences) and then adolescents aged 15 to 18 years.

Types of meningitis

Dr. Federico Artimón, head of the pediatric department at the University Hospital of Santiago de Compostela, explained at the seminar that There are 12 groups of meningococci, although 90% of meningitis cases in Europe are caused by 5 groups: groups A, B, C, W, Y.

In Spain, meningitis is caused mainly by meningococcal group B and, increasingly, by serotypes W and Y, which have doubled compared to the previous epidemiological season. Meningococcal serogroup C is very rare because it is already included in all vaccination schedules.

Vaccines against meningitis

• In addition to the vaccines included in all the vaccination schedules that I mentioned at the beginning (Haemophilus Influenzae type B (HiB), Meningitis C and Pneumococcus), there are other vaccines designed to protect against pneumococcal serotypes The most common.

MEn ACWY vaccine

This vaccine, called tetravalent (MenACWY protects against four types of meningitis.) Therefore, given the increased number of cases of meningitis type W and Y, the EPA recommends including it in vaccination schedules instead Meningitis C vaccine.

This vaccine is already included in the Castile-Leon vaccination schedule at 12 months and 12 years. The Canary Islands Government announced a month ago that it would include 12 years before the summer and the Government of Andalusia recently announced its inclusion at 12 months and at 12 years.

Bexsero (meningococcus B)

As I have already indicated, the meningococcal B vaccine (Bexsero) is not included in the Ministry of Health's single vaccination schedule, but it can be purchased at pharmacies with a pediatrician's prescription. The Canary Islands and recently Castile-Leon have announced their intention to include it in their vaccination schedule.

On vaccines, on the occasion of the X immunization days of the Vaccine Advisory Committee of the Spanish Pediatric Association, Dr. David Moreno, coordinator of the ASP Vaccine Advisory Committee, explained the following : "in 2017 -2018, in Spain, 40% of meningitis cases were caused by meningococcus B and nearly 40% of them in children under 5, the age when produces the highest percentage of cases, more serious and deadly.In particular, over the past nine years, there has been an average of 200 cases per year, "a figure that has slightly decreased until last season , while there had been a total of 142. "This one the decrease in meningitis B coincides with the availability of meningococcal B vaccine since 2015, unfunded

According to the AEP, with the incorporation into the official calendars of the two vaccines against meningococcus B and ACWY, as well as existing vaccines against Haemophilus influenzae type B and pneumococcus, our children would be virtually screened against all the meningitis of childhood " Therefore, the EPA hopes that the measures taken by Castilla-Leon and the Canary Islands will be followed by the rest of the autonomous communities.

To inform on all that has progressed in the prevention of meningitis, the Spanish Association of Pediatrics (AEP) has launched the campaign "Meningitis: Close the Circle." A "film" that deserves to be published. to be told. "