The state of Rio de Janeiro recorded an increase in cases of meningitis and meningococcal disease in 2022, according to the State Department of Health (SES). The folder, however, claims that there is no outbreak of the disease in Rio de Janeiro.
SES reported on Thursday (29) that, between January and August 2022, the number of cases of meningococcal disease in the state increased by 55.5% when compared to the same period in 2021. 30 cases were registered, eight patients died. In 2022, until August, there are already 28 notifications of the disease and seven deaths. If all cases of meningitis are considered, the 977 registered so far in the state already exceed the 959 recorded throughout 2021.
Any inflammation located in the meninges, the membranes that surround the brain and spinal cord, is called meningitis. The causative microorganisms can be viruses, bacteria, fungi and other agents. Viral meningitis are the most common and those that tend to evolve with less severity. Meningococcal disease is caused by different types of bacteria called meningococci, which can cause more serious meningitis or even meningococcemia, the generalized infection caused by meningococcus.
vaccines
The National 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; Penta, which prevents meningitis caused by the bacterium Haemophilus influenzae B, in addition to four other diseases; and the meningococcal ACWY vaccine, which protects against meningococcal serogroups A, C, W and Y. There are also bacterial meningitis caused by pneumococci, whose 10 main serotypes are prevented by the immunizing agent Pneumococcal 10-Valent.
The meningococcal C (conjugate) vaccine has been on the Brazilian vaccination schedule for the longest time, since 2010, because serotype C is the most prevalent in the country. Despite this, the coverage of this immunizer for children under 1 year of age has been falling in recent years. According to SES, in 2017, the rate was 91.32%; in, 2018, in 87.86%; in 2019, it reduced to 76.81%; in 2020, it dropped to 57.12%; and in 2021, it stood at 54.49%. In 2022, until September 22, the rate entered into the system was 36.38%.
Vaccination coverage for the year 2022 must still be updated in the database, because the numbers are subject to delays in filling out the forms by the municipalities.
The meningococcal C vaccination schedule provides for 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 to health workers and children up to 10 years of age. Children between 5 and 10 years old who have never received the immunizer should take only one dose and health workers should receive a booster dose, even if they already have a complete vaccination schedule.
The ACWY meningococcal vaccine is included in the calendar for children and adolescents aged 11 to 14 years, and immunization in this age group is important to contain circulation, since adolescents and young adults are the main responsible for the transmission of the disease in the country.
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 droplets of saliva.
The Penta vaccine, on the other hand, protects against the bacterium Haemophilus influenzae B, which also causes bacterial meningitis, in addition to preventing diphtheria, tetanus, whooping cough, and hepatitis B. The immunizer 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, until September 22, the rate is 34.67%.
The secretariat informs that, even with the end, this Friday (30), of the National Vaccination Campaign against Poliomyelitis and Multivaccination, all vaccines intended for the immunization of children and adolescents are still available at health posts, including the three immunizers that protect against meningitis.
The president of the Department of Infectious Diseases of the Brazilian Society of Pediatrics, Marco Aurélio Sáfadi, emphasizes that the vaccine is the main tool for preventing meningococcal disease.
“The manifestation of the disease is a crisis of symptoms, which is characterized by fever, headache and vomiting. This is the classic triad of meningitis. In addition, as there is infection in the meninges, there is stiff neck and other signs”, he describes. “These are always serious cases, which lead to prostration, torpor, a fall in general condition, they often have spots on the body and more serious manifestations. As a rule, this is the picture of bacterial meningitis.”
Sáfadi adds that babies with the disease will have groans, irritability and bulging of the soft spot, in addition to fever, vomiting and headache.
The doctor explains that, when a case of meningococcal disease is diagnosed, it is necessary to trace the contacts for medication with antibiotics, since most carriers of the bacteria do not show the symptoms of the disease, but can transmit it.
Source: CNN Brasil
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