MercoPress. South Atlantic News Agency

Rio de Janeiro says meningitis cases on the rise

Vaccination will still be available even after the end of the national campaign, Rio de Janeiro authorities explained

Health authorities in the Brazilian State of Rio de Janeiro have announced the number of cases of meningitis recorded so far in 2022 already exceeds those detected all throughout 2021.

According to the Rio de Janeiro State Health Secretariat (SES), there is no outbreak of the disease.

Meningitis is an inflammation of the meninges, the membranes that surround the brain and spinal cord. The microorganisms that cause it can be viruses, bacteria, fungi, and other agents. Viral meningitis is the most common and is less severe. On the other hand, meningococcal disease is caused by different types of bacteria called meningococci, which can cause more severe meningitis or even meningococcemia, the generalized infection caused by meningococcus.

The SES reported Thursday that between January and August 2022, the number of cases of meningococcal disease in the state increased 55.5% when compared to the same period in 2021. Throughout 2021, 30 cases of meningococcal disease were reported, with eight patients dying. In 2022, until August, there are already 28 notifications of the disease and seven deaths.

If all cases of meningitis are considered, the 977 recorded so far in the state already exceed the 959 counted throughout the year 2021.

Brazil'sNational Immunization Program offers different types of vaccines that protect against different types of bacterial meningitis: the meningococcal C (conjugate) vaccine, which prevents type C meningococcal disease; the Penta vaccine, which prevents meningitis caused by Haemophilus influenzae B bacteria, as well as four other diseases; and the meningococcal ACWY vaccine, which protects against meningococcal serogroups A, C, W, and Y. There is also bacterial meningitis caused by pneumococci, whose 10 main serotypes are prevented by the Pneumococcal 10-Valent vaccine.

The meningococcal C (conjugate) vaccine is the one to have been on the Brazilian vaccination calendar for the longest time, since 2010, because serotype C is the most prevalent in the country. Despite this, the coverage of this immunization for children under 1 year has been falling. According to the SES, in 2017, the rate was 91.32%; in, 2018, 87.86%; in 2019, it reduced to 76.81%; in 2020, it fell to 57.12%; and in 2021, it was 54.49%. In 2022, as of September 22, the rate entered into the system was at 36.38%.

Vaccination coverage for the year 2022 must still be updated in the database because the numbers are subject to delays in the completion of the forms by the municipalities, it was explained.

The meningococcal C vaccination schedule provides two doses, at 3 and 5 months of age, and a booster, which should preferably be done at 12 months of age. The SES also recalls that in July this year, the Ministry of Health expanded the supply of meningococcal C vaccine for health workers and children up to 10 years old. Children between 5 and 10 years who have never received the immunization should take only one dose and health workers should receive a booster dose, even if they already have a complete vaccination scheme.

The meningococcal ACWY vaccine is scheduled for children and adolescents from 11 to 14 years old, and immunization in this age group is important to contain circulation since adolescents and young adults are the main liable for the disease's transmission nationwide.

About 10% of adolescents and adults are asymptomatic carriers of meningococcus in the throat and can transmit the bacteria even without getting sick, through respiratory secretions, such as saliva droplets.

The Penta vaccine, on the other hand, protects against the Haemophilus influenzae B bacterium, which also causes bacterial meningitis, besides preventing diphtheria, tetanus, pertussis, and hepatitis B. The immunization should be applied to children at 2, 4, and 6 months of age, but coverage is also falling: 93.49% in 2017; 88.16% in 2018; 55.15% in 2019; 55.77% in 2020; and 54.27% in 2021. This year, as of September 22, the rate is at 34.67%.

The SES said that despite the National Vaccination Campaign against Poliomyelitis and Multivaccination ending Sept. 30, all vaccines for the immunization of children and adolescents are still available at the health posts, including the three immunizers against meningitis.

The chairman of the Infectious Diseases Department of the Brazilian Society of Pediatrics, Marco Aurélio Sáfadi, pointed out that the vaccine is the main prevention tool against meningococcal disease.

“The manifestation of the disease is a flare of symptoms, which is characterized by fever, headache, and vomiting. This is the classic triad of meningitis. In addition, since there is an infection in the meninges, there is neck stiffness and other signs,” he added. “They are always severe cases, which lead to prostration, numbness, a drop in general condition, often with spots on the body and more serious manifestations. As a rule, this is the picture of bacterial meningitis.”

Sáfadi also pointed out that babies with the disease will present moaning, irritability, and bulging of the brain, besides fever, vomiting, and headache.

The physician also explained that when a case of meningococcal disease is diagnosed, it is necessary to screen contacts for antibiotic medication, since most carriers of the bacteria do not show symptoms of the disease, but can transmit it.

(Source: Agencia Brasil)