Bacterial meningitis precautions
To further reduce the burden of the disease, any close contact of infected patients should get a prophylactic antibiotic to protect them against bacteria that may have been transmitted. This prophylactic measure is performed to stop bacterial meningitis from spreading. It is worth noticing that meningitis is considered a seasonal disease, and the rates of infection increase in the winter season, especially on January, February and March. But the real question is whether or not these preventative measures work? Did the rate of infection dropped or it is just a big hoax?
Rates of meningococcal infection are declining in America since late 1990s. In 2017, there was only 350 total cases of meningitis, which is a great success that proves that we are on the right path. Unfortunately, this is still not the case for African countries. We have a termed meningitis belt in sub-Saharan Africa, where bacterial meningitis is still a serious and common condition. The rates are very high, up to 1000 cases for every 100,000 people, and major epidemics are very commonly occurring as short as every 5 years. They also have a special type of bacteria than other countries, which is serogroup A accounting for 90% of meningococcal disease cases, and the majority of large-scale epidemics. But the World Health Organization is doing its best to stop this devastating disease from causing more damage in these places.
Starting in 2010, meningitis belt countries began implementing mass vaccination campaigns for a monovalent serogroup a meningococcal conjugate vaccine (MenAfriVac®). Held in 22 of the 26 target countries as of December 2018, these campaigns vaccinated 1 through 29 year olds. In addition, 8 countries introduced the vaccine into the routine childhood immunization program. The statistics show that the number of infected people are declining, and epidemics are almost eliminated in many countries. On Europe, America, Australia and Egypt the most common serotype of the bacteria isn’t serotype A. Serotypes B, C, and Y are the most common, accounting for the majority of cases in Europe, America and Australia.
Handling bacteria isn’t that easy and they will not give up without fighting. As we progress in developing ways to prevent and treat the bacteria to stop bacterial meningitis, bacteria create resistance and changes its serotypes as a way of response. This is very clear, and can be seen in the Africa case. Following vaccination, the outbreaks decreased in frequency, but now we see the type of bacteria that causes meningitis is no longer serotype A but serotypes C and W.
We have even seen an outbreak of a not well-known serotype called serotype X. These cases prove that bacteria won’t surrender easily, and we need good and continuous surveillance to control the different strains that cause bacterial meningitis. We have to adapt fast to the changes as well if we want to keep the disease under control and stop the epidemics that might occur. Creating new and more effective vaccination schedules is required, and changing the regime of treatment in response to the new surveillance data we get is also important. For example, changing the vaccine we use in Africa or adding another vaccination after the change of serotypes we have witnessed. We now have to apply other vaccines to control the other common serotypes that started to cause epidemics. The World Health Organization has to collaborate and join efforts with the different African health ministries to adjust the regime and control bacteria by applying the appropriate vaccines for the serotypes that prevail in every country. Being always ready to adjust your regimes is what we need to stand together smart against this devastating disease.
