Meningo­coc­cal Dis­ease

mailife - - Contents - By DR KRU­PALI TAP­POO

Over the past few weeks there has been much at­ten­tion in the me­dia re­gard­ing meningo­coc­cal dis­ease in Fiji af­ter the health au­thor­i­ties de­clared an out­break. Cases of meningo­coc­cal dis­ease in Fiji have con­sis­tently in­creased from 1-10 cases in to­tal be­fore 2016 to 29 cases in 2016, 48 in 2017 and as of 21 Fe­bru­ary there were al­ready 18 cases re­ported in 2018. (Min­istry of Health and Med­i­cal Ser­vices) Many peo­ple are con­cerned re­gard­ing this out­break and are won­der­ing what they can do to pro­tect them­selves. Some are won­der­ing whether this is a new dis­ease. In fact menin­gi­tis has been de­scribed in an­cient texts. Hip­pocrates (the fa­ther of medicine) de­scribed menin­gi­tis in his work. An out­break of menin­gi­tis was first recorded in Geneva in 1805. Gas­pard Vieusseux (1746-1814) and An­dre Matthey (1778-1842) in Geneva, and Elisa North (1771-1843) in Mas­sachusetts, de­scribed epi­demic (meningo­coc­cal) menin­gi­tis. Sev­eral other epi­demics in Europe and the United States were de­scribed shortly af­ter­ward.In gen­eral meningo­coc­cal dis­ease is a rare but se­ri­ous con­di­tion. Meningo­coc­cal dis­ease is an acute bac­te­rial in­fec­tion that can cause death within hours if not recog­nised and treated in time. Although the ma­jor­ity of vic­tims will re­cover fully, 10% of those in­fected will die and around 20% will have per­ma­nent dis­abil­i­ties -- rang­ing from learn­ing dif­fi­cul­ties, sight and hear­ing prob­lems, to liver and kid­ney fail­ure, loss of fin­gers, toes and limbs and scar­ring caused by skin grafts. One of the rea­sons meningo­coc­cal dis­ease is hard to iden­tify is that it can ap­pear in sev­eral dif­fer­ent forms, depend­ing on which part of the body the bac­te­ria

in­vade: menin­gi­tis (af­fect­ing the brain and spinal cord) or sep­ti­caemia (af­fect­ing the blood), or a com­bi­na­tion of both. Menin­gi­tis is in­flam­ma­tion of the lin­ing of the brain and spinal cord. There are many dif­fer­ent forms of menin­gi­tis -- fun­gal, vi­ral and bac­te­rial. Bac­te­rial menin­gi­tis, also called meningo­coc­cal dis­ease, is the most se­ri­ous form. Symp­toms may in­clude a se­vere headache, fever, fa­tigue, stiff or painful neck, sen­si­tiv­ity to light or con­vul­sions. Meningo­coc­cal menin­gi­tis can re­sult in per­ma­nent dis­abil­i­ties – such as deaf­ness or brain in­jury – and can in some cases cause death. Meningo­coc­cal sep­ticemia is the most dan­ger­ous and deadly type of meningo­coc­cal dis­ease. It hap­pens when the bac­te­ria en­ter the blood­stream and mul­ti­ply un­con­trol­lably , dam­ag­ing the walls of the blood ves­sels and caus­ing bleed­ing into the skin (which re­sults in the dis­tinc­tive rash). Symp­toms may in­clude fever, fa­tigue, vom­it­ing, cold hands and feet, cold shiv­ers, se­vere aches or pain in the mus­cles, joints, chest or ab­domen, rapid breath­ing, di­ar­rhoea – and, in the later stages, a pin­prick or pur­ple bruise-like rash. Those most at risk in­clude chil­dren under the age of five as their im­mune sys­tem is less ma­ture and they have the ten­dency to put things into their mouth. In ad­di­tion, teenagers and young adults from 15-24 years are also at risk as they lead very so­cially in­ter­ac­tive life. The dis­ease spread­sthrough res­pi­ra­tory or throat se­cre­tions and gen­er­ally hap­pens by cough­ing or kiss­ing a per­son or close house­hold con­tact. There is treat­ment avail­able and a per­son needs to be treated ur­gently with ap­pro­pri­ate an­tibi­otics. If you are con­cerned it’s best to visit your doc­tor or go to the hos­pi­tal emer­gency depart­ment. There are var­i­ous dif­fer­ent strains of bac­te­ria that cause meningo­coc­cal dis­ease. During the cur­rent out­break the strain is mostly the C group. There are vac­cines avail­able glob­ally which cover the C strain, B strain and a poly­va­lent vac­cine with ACYW. Cur­rently there are very few coun­tries which can af­ford to have the costly vac­cine as part of the rou­tine free child­hood im­mu­niza­tion sched­ule, in­clud­ing the smaller Pa­cific is­lands in­clud­ing Tonga, Samoa, Van­u­atu, Solomons and Fiji. At the mo­ment pri­vate phar­ma­cies are or­der­ing in the the poly­va­lent and C group vac­cine. It is best to dis­cuss this with your doc­tor if you would like to get your child or your­self vac­ci­nated. Hope­fully, in the very near fu­ture, the meningo­coc­cal vac­cine will be avail­able ei­ther for free or at a sub­sided cost to all chil­dren in Fiji. Wise words by Henry de Brax­ton “An ounce of pre­ven­tion is worth a pound of cure.”

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