“Meningitis is not a common pathology, but this infection in 24 hours, even less, in adolescents, rapidly passes from the first symptoms, which are non-specific and flu-like, to hospitalization with very diversified clinical pictures, up to death, unfortunately”. Vincenzo Baldo, full professor of Hygiene at the University of Padua explains this to time.news Salute, commenting on the case of the 17-year-old from Bassano (Vicenza) hospitalized for meningitis B on Saturday 25 February, for whom hope has been lost and the procedure for declaring brain death.
“The meningococcal B vaccine is effective – underlines Baldo – It is already offered to newborns and, in some regions, also to adolescents. The new vaccination plan should standardize the situation at national level. Currently, in fact, in the 12-18 age group years the quadrivalent covering the ACWY strains has been proposed, but not the one for type B which is the most widespread.Already in 2019 the scientific societies of hygiene and preventive medicine (Siti), of paediatricians (Fimp) and of general practitioners (Fimmg) asked to recommend it in adolescents, given that the peaks of the infection occur in young children and adolescents”.
In the specific case, for the closest contacts of the young person, more than 250 people, antibiotic prophylaxis was promptly activated which acts, in the event of contagion, within the incubation period, before the disease develops. “Remember that the transmission can occur through very close contacts – highlights the expert – Even if the meningococcus has an epidemic potential, the preventive measures, adopted in a timely manner, significantly reduce the possibility of having secondary cases”.
Meningitis “is frightening, even irrationally, and is fueled by a lack of information – reflects Baldo – This fear has its justification in the speed and violence with which this pathology strikes. In fact, meningococcus has the ability to adapt, change capsule, the outer coat, maintaining the same degree of virulence (the ST11 strain is the strongest) and escape the immune response. Added to this is its ability to replicate quickly, which does not give time to intervene”.
From an epidemiological point of view, “young adults are also defined as central to the transmission of meningococcus – continues the teacher – 24% may be healthy carriers, according to some studies, but it is not known why the disease develops in some cases which, based on the virulence of the strain, has important sequelae – 20% have hearing loss, epilepsy, brain damage, learning disabilities, amputation of limbs, scars – in addition to the related psychological and care burden”.
The latest report from the Higher Institute of Health (ISS) on surveillance shows that in 2021 “26 cases of invasive meningococcal disease were reported, significantly lower than in previous years – 74 and 190 were reported in 2020 and 2019 , respectively – but this has certainly been induced, given the mode of transmission of the microorganism by air – the specialist points out – by the preventive measures adopted in the fight against Covid. Unfortunately in the last period, and the Veneto case demonstrates it, we are witnessing the return of cases of this pathology”.
Among the different serogroups, “type B is the most frequent, followed by C – recalls Baldo – In the last period W and Y have increased. For almost all strains there is an opportunity for prevention which is vaccination – the expert reiterates – We have the ACYW polysaccharide conjugate vaccines available against meningococcus and the protein vaccines against meningococcus B. The quadrivalent is offered free of charge to children in their 13th month of life, adolescents aged 14-15 and people with pathologies that can predispose you to a greater risk of developing meningococcal disease. As for the meningococcal B vaccine, it is offered in the first year of life. There is the possibility of receiving it even in adolescence, but it depends on the region ” .
“Vaccines are highly effective – repeats Baldo – The English experience also confirms this: they quickly achieved large coverage rates and significantly reduced cases”.