Last month, health officials in Brazil reported the confirmation of an outbreak of meningococcal disease caused by serogroup C in the state of São Paulo.
Five cases were reported. This is the most frequent cause of bacterial meningitis in Brazil.
This has prompted the health ministry to reinforce the importance of vaccinating children and adolescents against meningitis.
In Brazil, meningitis is considered an endemic disease. Cases are expected throughout the year, with occasional outbreaks and epidemics. Bacterial meningitis is more common in autumn and winter and viral meningitis is more common in spring and summer.
Meningitis is an inflammation of the meninges, membranes that surround the brain and spinal cord, and can be caused by bacteria, viruses, fungi and parasites. Viral and bacterial meningitis are the most important for public health, considering the magnitude of their occurrence and the potential to produce outbreaks.
Being a serious and contagious disease, meningitis is capable of causing sequelae and even death. Vaccination is the most effective way to prevent infection. For meningococcal meningitis, the following vaccines are available:
- Meningococcal C (Conjugate): protects against meningococcal disease caused by serogroup C. Vaccination schedule: 1st dose at 3 months of age; 2nd dose at 5 months of age and booster at 12 months of age;
- Meningococcal ACWY (Conjugate): protects against meningococcal disease caused by serogroups A, C, W and Y. Vaccination schedule: one dose in adolescents aged 11 and 12, depending on vaccination status.
In addition, bacterial meningitis caused by other forms can be prevented by these five vaccines:
- BCG: protects against severe forms of tuberculosis, including tuberculous meningitis. Vaccination schedule: single dose (at birth);
- Penta: protects against invasive diseases caused by Haemophilus influenzae serotype B, such as meningitis and also against diphtheria, tetanus, whooping cough and hepatitis B. Vaccination schedule: 1st dose at 2 months of age; 2nd dose at 4 months of age and 3rd dose at 6 months of age;
- 10-Valent Pneumococcal (Conjugated): protects against invasive diseases caused by Streptococcus pneumoniae, including meningitis. Vaccination schedule: 1st dose at 2 months of age; 2nd dose at 4 months of age and booster at 12 months of age;
- 23-Valent Pneumococcal (Polysaccharide): protects against invasive diseases caused by Streptococcus pneumoniae, including meningitis. One dose is sufficient to provide protection against the pneumococcal serotypes contained in the vaccine. It is available to the entire indigenous population over 5 years of age, without proof of the 10-valent pneumococcal vaccine (Conjugate). For the population over 60 years of age (institutionalized), revaccination is indicated only once, and should be performed 5 years after the initial dose;13-Valent Pneumococcal (Conjugated): protects against invasive diseases caused by Streptococcus pneumoniae, including meningitis. This vaccine is available at the Reference Centers for Special Immunobiologicals (CRIEs) for the following special groups: individuals ≥ 5 years of age, including adults with HIV/AIDS conditions, cancer patients, solid organ transplants and hematopoietic stem cell transplant recipients. (bone marrow)
The National Immunization Program (PNI) is also making the meningococcal C vaccine available to unvaccinated children up to 10 years of age and to health workers. Likewise, the meningococcal ACWY vaccine is being offered temporarily to unvaccinated adolescents 11 to 14 years of age .
The meningococcal ACWY (Conjugated) vaccine is available on the National Vaccination Calendar for 11- and 12-year-olds, but by June 2023 13- and 14-year-olds will also be able to get vaccinated. The expansion aims to reduce the number of carriers of the bacteria in the nasopharynx.
The age group with the highest risk of illness are children under one year of age, however, adolescents and young adults are primarily responsible for maintaining the circulation of the disease.
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