Meningococcal vaccination is vital
Last week, Pharmac announced that, from December 1, young people aged 13-25 years, in ‘‘close-living situations’’, will be eligible for a funded meningococcal vaccine. This is great news and I encourage anyone who meets the criteria to take advantage of this opportunity.
Sadly, this funding decision only covers a vaccine known as Menactra. Menactra protects against four strains of the meningococcal disease (A, C, W and Y) but doesn’t cover the common B-strain of the disease.
We do have a vaccine available that protects against meningococcal B (known as Bexsero) but, as yet, it’s only available if you can fund it yourself, which is no mean feat at $200-$300 for a course.
Watch this space though, as I gather Bexsero is firmly on Pharmac’s radar, so fingers crossed funding for that vaccine as well may be available before too long.
Meningococcal disease is caused by a group of bacteria known as Neisseria Meningitidis. There are at least 12 different strains of this bacteria around the world, including A, B, C, W and Y.
Historically in New Zealand, most cases have been caused by the B-strain, but last year this changed, when about 50 per cent of reported cases were from the Y, W and C strains. The A strain is very rare here, but is more prevalent overseas.
Anyone can catch meningococcal infection and, in fact, about 15 per cent of us will already carry this bacteria in our noses or throats without becoming unwell.
The bacteria is spread in saliva droplets, so coughing, sneezing, sharing cups or water bottles and kissing can all lead to transmission.
We don’t fully understand why it can cause such a terrible infection in some people, while others can be exposed to it without any ill effects at all.
However, we do know that some groups are at particularly high risk:
■ All infants and children under 5
■ Ma¯ ori and Pasifika people, especially babies
■ Teenagers and young adults, especially those living in close proximity to others, such as university accommodation or boarding school
■ Smokers
■ Anyone with a co-existing ‘‘respiratory tract infection’’, such as the flu or a common cold
■ People with a lowered immune system – this can result from certain types of immune deficiencies, or from taking medication such as long-term steroids or immunosuppressants.
Meningococcal infection can cause three types of illness: meningitis (an infection of the lining around the brain), meningococcal septicaemia (an infection of the blood) and pneumonia (infection of the lungs).
All are extremely serious and meningococcal infection carries a high mortality rate of around 10-20 per cent.
In the very early stages, meningococcal infection can be relatively mild, with fever, malaise, headache and a runny nose, and can be very hard to differentiate from simple flu.
However, the following symptoms could be a clue that meningococcal is the cause, and getting to a doctor immediately is essential – even delaying by a few minutes can make all the difference:
■ Rapid progression of symptoms – people can deteriorate within hours or even minutes at times, as opposed to typical cold and flu viruses where the course tends to be more gradual
■ Very high fever
■ Muscle aches and pains
■ Persistent headaches
■ Stiffness or pain in the neck
■ Dislike of bright lights
■ Floppiness and lethargy – this can be especially prominent in babies who may be too tired to feed
■ Vomiting
■ Confusion
■ A rash – if septicaemia is developing, a typical rash will appear. This purply-red rash won’t ‘‘blanch’’ (go white) when pressed.
Although antibiotics given early enough in very high doses can stop meningococcal in its tracks, even those who survive will often have long-lasting complications, including hearing loss, brain damage, seizures or limb amputations.
Hence, as is so often the case, prevention (in the form of vaccination) is definitely preferable to cure.
To access the newly funded Menactra vaccine, you need to be 13-25 years of age and be in a closeliving situation with others. So this includes people in boarding schools, hostels, university halls of residence, prisons and other institutions.
The first year of the new funding includes what is called a ‘‘catch-up’’ programme – this means that anyone in that age range and living in that type of accommodation can get the vaccine for free but, from December next year, it will only be people starting their first year who will have access.
Others will be assumed to have been vaccinated during the catch-up phase.
Alongside this group, Menactra is also funded for a small number of other people – those who are immunosuppressed (either by medication such as steroids or chemotherapy, or because they have HIV, or are lacking a spleen) and those who are in