Priscilla Lynch: 'Parents need to know the facts about meningitis'

A spike 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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