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Does the Meningitis Shot Prevent Meningitis?

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

This article originally appeared on page 24 in the May 10-11, 2003 issue of
The Mississauga News under the feature: Health & Wellness, Doctor's Corner.

The answer is partly. The problem is in the jargon. The main thing to understand is that "meningitis" is a rare disorder that refers to an inflammation of the brain. To get past the immune system and into the brain is no easy task, and it rarely occurs. There are numerous causes: viruses, bacteria, parasites and even fungi. The scary part is that when it does occur, it is usually caused by an organism that the body may have seen and repulsed in another area such as the throat or ear. Viral meningitis is commonly referred to as aseptic meningitis. It is less severe and most people actually recover. There are at least 10 different viral families that can cause meningitis including measles, mumps, herpes, influenza, varicella (chicken pox), Epstein-Barr and West Nile virus. There are also at least 10 different bacteria families and numerous species which can cause meningitis. Among those we have Neisseria meningitides (commonly called meningococcus), Haemophilus influenzae serotype b (Hib), Streptococcal pneumonia (pneumococcal), Staphylococcus aureus and others. The great majority of us have had infections with these organisms, and have survived without developing the signs of brain invasion or "meningitis". In the rare healthy person, why one of these agents can invade the brain is still not completely understood. Similar confusion rests with contagiousness. Generally, only some of the bacterial causes are considered contagious, and antibiotics can be used in close contacts to prevent the spread in some cases.

The newest meningitis shots are called Menjugate and NeisVacc-C. They were developed to target one subgroup within one family of the bacterial causes. In Mississauga, we have seen a few deaths over the last dozen years from this sub-type which had been associated with sports teams, and possible sharing of water bottles. These shots can provide immunity against the group C subtype of Neisseria meningitis. Confusion often arises when one listens to manufacturers and the medical community alike communicate. We tend to shorten terms. Neisseria meningitidis is often referred to only as meningococcus, implying sole causation. These should not be confused with an older vaccine called "Menomune" which helped prevent invasion by yet other sub-types of meningococcal bacteria and nothing else. To prevent Meningitis as a disease entity would require a very large series of immunizations. Infants routinely receive several publicly funded vaccines which provide immunity against invasion by measles, mumps, influenza viruses and Haemophilus influenzae (H.Flu. for short). Introducing the H.Flu. shot to infants in the early 1990s almost eradicated the rare instances of meningitis due to this bacterial strain. Once you eliminate one cause, the next one on the list tends to move up and takes its place. For those who like to split hairs, even getting the influenza or "flu shot" can be viewed as yet another way of preventing a rare meningitis cause.

The latest meningitis shot is not publicly funded and costs over $100.00. Meningitis, being a rare but potentially fatal disease, strikes fear into the hearts of most parents. The latest shot is as safe as the flu shot. Getting the shot will protect you against only one bacterial cause of meningitis. There is no guarantee that you or your child will be protected against all causes of meningitis. This is an important consideration. The cost makes the decision difficult and ethical. Should only those who can afford it be given the shot? Safeguarding your kids is expensive and difficult. Do you purchase new shots, or should the money go to other proven prevention strategies such as helmets and swim lessons? There are strategies that can ease the burden. The costs usually come down with increased sales. Health departments or other agencies may decide to purchase bulk supplies and re-sell to the public at a reduced rate. With the boom of genetic technology, you can be certain that there will be many more shots coming onto the market for other meningitis causes soon. Generalizing that meningitis can be prevented is erroneous at this point. At best, we are reducing the incidence of the fatal strains, through multiple immunization programs.

Related resources:

Meningococcal Disease from Centers for Disease Control and Prevention (CDC), Division of Bacterial and Mycotic Diseases. FAQs: What is meningitis? What are the signs and symptoms of meningitis? How is meningitis diagnosed? Can meningitis be treated? Is meningitis contagious? Are there vaccines against meningitis?
Meningococcal Disease - Communicable Disease Fact Sheet. What is meningococcal meningitis? How is the meningococcus germ spread? From Department of Health, New York State.
Meningococcal Meningitis Vaccination (Menomune) from Cowell Student Health Center, University of California, Davis.
Meningitis - meningococcal from MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine, National Institutes of Health (NIH), Department of Health & Human Services.
Meningitis: Questions & Answers from CDC - Centers for Disease Control and Prevention.

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