MENIN­GI­TIS — THE FACTS

What ev­ery par­ent needs to know

Sunday Independent (Ireland) - - Front Page -

ASPIKE in menin­gi­tis cases lead­ing to three deaths is caus­ing con­cern and un­ease among par­ents.

The HSE an­nounced that there have been 11 cases of meningo­coc­cal dis­ease re­ported since the last week of 2018, more than dou­ble the five cases for the same time pe­riod last year.

While meningo­coc­cal dis­ease in­ci­dence gen­er­ally in­creases in win­ter, the re­cent in­crease is cause for con­cern. In 2018, a to­tal of 89 meningo­coc­cal cases were re­ported com­pared to 76 in 2017, so the po­ten­tially fa­tal dis­ease is con­tin­u­ing to rise in Ire­land.

The lat­est meningo­coc­cal cases oc­curred in Dublin and other re­gions, and af­fected all age groups, from in­fants to el­derly. The dis­ease and deaths have been caused by mul­ti­ple strains of meningo­coc­cal bac­te­ria, the HSE has con­firmed.

So what can be done to re­duce the risks of con­tract­ing menin­gi­tis? The HSE said par­ents should en­sure that their chil­dren have re­ceived all their vac­cines on time.

A vac­cine that pro­tects against meningo­coc­cal C dis­ease (MenC vac­cine) is given at six months and at 13 months; and meningo­coc­cal B vac­cine (MenB vac­cine) is given at two, four, and 12 months of age. In ad­di­tion, ado­les­cents are rou­tinely of­fered the MenC vac­cine in the first year of sec­ondary school. Older teenagers and young adults up to 23 who never re­ceived a MenC vac­cine are rec­om­mended to get the vac­cine.

Other vac­cines that pro­tect against other forms of menin­gi­tis and sep­ti­caemia are in­cluded in the rou­tine child vac­ci­na­tion pro­gramme (Hib vac­cine) and pneu­mo­coc­cal vac­cine (PCV).

While all chil­dren should get their vac­cines in ac­cor­dance with the na­tional sched­ule, chil­dren who have missed vac­cines can ob­tain them from their GPs.

How­ever, as the MenB vac­cine was only in­tro­duced in re­cent years to cover ba­bies born from Oc­to­ber 1, 2016, par­ents of young chil­dren not el­i­gi­ble for it are un­der­stand­ably wor­ried.

In the past few days, GPs across the coun­try have been in­un­dated with calls from par­ents about vac­ci­nat­ing their chil­dren pri­vately with the MenB vac­cine, which can cost be­tween €300-450. Not cheap.

This has led to re­newed calls and pe­ti­tions for the HSE to fund the vac­cine for older chil­dren not el­i­gi­ble for the cur­rent pro­gramme.

Last Fri­day, the Na­tional As­so­ci­a­tion of Gen­eral Prac­ti­tion­ers (NAGP) called for a na­tional Menin­gi­tis B catch-up vac­ci­na­tion pro­gramme for chil­dren born be­fore Oc­to­ber 2016, up to the age of 18 years. Dr Maitiu O Tuathail, pres­i­dent of the NAGP, said many par­ents say they can­not af­ford the cost of vac­ci­nat­ing their chil­dren pri­vately.

“We are call­ing on the Min­is­ter for Health, Si­mon Har­ris, to im­me­di­ately ad­dress this in­ex­cus­able in­equal­ity. We can­not al­low it to con­tinue. We need to pro­vide pro­tec­tion to all of our chil­dren equally.

“The chil­dren of Ire­land de­serve equal­ity in terms of vac­ci­na­tion cov­er­age, this is cur­rently not the case.”

How­ever, the De­part­ment of Health and HSE had re­jected calls for a catch-up pro­gramme. The HSE said of the three pa­tients who died, two dif­fer­ent meningo­coc­cal strain types were iden­ti­fied, nei­ther of which were MenB. It added that most cases of MenB are seen in chil­dren un­der one year of age.

The de­part­ment said that the Na­tional Im­mu­ni­sa­tion Ad­vi­sory Com­mit­tee, an ex­pert group that ad­vises on what vac­cines should be pub­licly funded based on the best med­i­cal ev­i­dence avail­able, has not rec­om­mended a MenB vac­cine catch-up pro­gramme for chil­dren born be­fore Oc­to­ber 1, 2016.

The HSE also notes a drop in the up­take of meningo­coc­cal vac­cines among chil­dren in Ire­land in re­cent years.

In Q2 2018, the up­take of MenC (first dose) for ba­bies at 12 months was 90pc; the up­take for two doses of MenB at 12 months was 93pc, and the up­take of MenC at 24 months was 88pc. Among ado­les­cents (first year in sec­ondary school), the up­take of MenC vac­cine dur­ing the 2016-2017 aca­demic year was 83.9pc

While these fig­ures seem high, an up­take of 95pc is re­quired to pro­vide “herd im­mu­nity”, to re­duce the chances of in­fec­tion, and pro­tect those who are too young to be vac­ci­nated, were not el­i­gi­ble for free vac­ci­na­tion, or can­not get vac­ci­nated for med­i­cal rea­sons.

In the mean­time, the HSE wants the pub­lic to be alert to the signs and symp­toms of meningo­coc­cal dis­ease. This is so im­me­di­ate med­i­cal at­ten­tion can be sought if some­one has symp­toms that could be caused by this dis­ease.

“If any­one has any con­cerns about menin­gi­tis they should ring their GP in the first in­stance,” said Dr Suzanne Cot­ter, spe­cial­ist in Pub­lic Health Medicine, at the HSE Health Pro­tec­tion Surveil­lance Cen­tre.

“Menin­gi­tis and sep­ti­caemia of­ten hap­pen to­gether and symp­toms can ap­pear in any or­der. Some may not ap­pear at all. Early symp­toms can in­clude; fever, headache, vom­it­ing, di­ar­rhoea, mus­cle pain, stom­ach cramps, fever with cold hands and feet and a rash, but do not wait for the rash to ap­pear.

“If some­one is ill and get­ting worse, get med­i­cal help im­me­di­ately.”

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