After Covid-19, “an unprecedented uptick” in meningitis cases in France

The Pasteur Institute warns this Wednesday, November 15, 2023, of an “unprecedented uptick” in cases of potentially fatal meningococcal meningitis, following the cessation of health measures taken during Covid-19 in France, it reportsAFP. The institute is calling for the vaccine to be expanded to adolescents, who are particularly affected.

Meningitis is an infection of the coverings around the brain and spinal cord. In most cases they are viral, but they can also be of bacterial origin: this is the case with meningococcal meningitis, the news agency recalls.

Also read: “There is an increase in certain meningitis”: our interview with a specialist

About one in three adolescents is a meningococcal carrier

Transmission occurs from person to person through close and prolonged contact. About one in ten people in the general population (but one in three adolescents) carry meningococcus without showing symptoms of the disease. But it happens that meningococci, after infecting the respiratory tract, spread through the blood circulation in the body.

The main symptoms are high fever, severe headache, vomiting, stiff neck, light sensitivity, red or purplish spots (purpura), etc. Unpredictable and devastating, without prompt treatment this disease can cause death within 24 hours. With proper treatment, mortality remains 10%.

Also read: “I’ve had Covid five times”: why have some people contracted the virus many times?

Meningococcal meningitis can also have more or less serious consequences: amputation, deafness, cognitive impairment, learning difficulties, etc.AFP.

Infections falling during the Covid-19 epidemic

During the Covid-19 epidemic, barrier gestures such as wearing a mask and social distancing had positive effects on respiratory infections, the Pasteur Institute recalls. This was the case for meningococcal meningitis, where the number of infections fell by more than 75% in 2020 and 2021. But the reference center wondered what the future would be, when the protective measures would be relaxed.

Scientists closely studied the evolution of the disease between 2015 and 2022 and observed a rapid resumption of bacterial activity.

“Meningococcal meningitis experienced an unprecedented recovery in the fall of 2022, with today, in the fall of 2023, a number of cases higher than in the period prior to the Covid-19 pandemic”summarizes Samy Taha, one of the authors of a study published in the journal last month Journal of Infection and Public Healthand researcher at the Invasive Bacterial Infections Department of the Institut Pasteur.

If 298 cases were registered between January and September 2019, 421 cases have already been registered between January and September 2023, an increase of 36%. “Even though the winter peak has not yet occurred”points Pasteur.

Levels “never reached” in France

These levels recorded in 2023 are levels “never achieved” so far in France, emphasizes Muhamed-Kheir Taha, head of the National Reference Center for Meningococci. According to the research institute, there are two important explanations for thisAFP : a decrease in general immunity due to the decrease in the circulation of strains, but also the decrease in vaccination, which, for example, decreased by 20% for vaccination against meningococcal C during the first childbirth.

Different types of envelopes or capsules surround the bacteria. In the case of meningococci, the nature of these envelopes is indicated by letters. Today, in France, only vaccination against meningococcal group C has been mandatory since 2018, and since 2022, vaccination against meningococcal B is simply recommended in infants.

“Reconsider the vaccination strategy”

Unlike some countries such as Great Britain, there are no recommendations yet for the general population against groups Y and W. However, since the end of the pandemic, the latter strains have been responsible for most meningitis. “We believe it is time to reconsider the current vaccination strategy”indicates to theAFP Muhamed-Kheir Taha.

The researchers, currently working with the High Authority for Public Health (HAS), recommend in particular extending the tetravalent vaccine, targeting meningococcal groups A, C, Y and W, to adolescents, the main healthy carriers of meningococcal.

Especially since the resurgence of meningitis could increase in the coming months due to the seasonal flu epidemic that has caused a… “context favorable for the development of meningococcal bacteria”, particularly by increasing circulation and exposure to respiratory pathogens. Another point of vigilance: large gatherings that promote contagion, such as the Olympic Games.

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