New vaccine to tackle spread of killer disease

File photo.

Bay of Plenty parents of infants, toddlers and adolescents can now immunise their children against the country's most common type of meningococcal disease with the launch of a new vaccine.

Last year there were three confirmed cases of meningococcal B in Bay of Plenty which represents four per cent of the total incidence of group B strains that have occurred nationwide.

A further four cases were also notified within the Bay of Plenty region in the first six months of 2018.

Meningococcal disease is an uncommon but life-threatening bacterial infection causing two serious illnesses: meningitis (an infection of the membranes that cover the brain) and septicaemia (blood poisoning).

Even with appropriate medical care, around one in every ten patients who contract the disease will die, and up to one in five survivors will have permanent disabilities; such as brain damage, amputated limbs and hearing loss.

In New Zealand meningococcal B can strike at any age, but is most frequent in babies and children under five, followed by teenagers. Meningococcal B rates in Maori and Pasifika infants under one are about six times higher than other populations in New Zealand.

Vaccinologist, Senior Lecturer in the Department of General Practice and Primary Health Care at Auckland University Dr Helen Petousis-Harris, says meningococcal B is a rapid and unpredictable disease which can cause death within 24 hours.

Due to its flu-like symptoms meningococcal B can be difficult to diagnose, but can progress quickly. Along with headaches, fever, and a sore neck, patients may also present with a rash.

'Meningococcal B is a disease that every parent knows about and every doctor is terrified of missing, it's a disease we're all scared of,” she says.

A strain of the disease specific to New Zealand, resulted in a significant and prolonged meningococcal B epidemic between 1991 and 2007 resulting in 6128 cases and claiming 252 lives. In response to the epidemic, a short-term nationwide vaccination programme using a tailor made vaccine (MeNZB) was introduced from 2004-2008.

Helen says toddlers who were immunised during the last epidemic will now be entering the high risk adolescent age group and will need to be vaccinated again if protection from the disease is to be maintained.

The new vaccine, Bexsero, includes the active component of the MeNZB vaccine, as well as three other antigenic components to help improve strain coverage.

She says infants are one of the most vulnerable groups who need to be immunised against meningococcal B.

'Infants will have not yet developed natural immunity which is gained via the harmless carriage of both meningococcal and other similar bacteria. In other words their bodies have not been educated to protect them against meningococcal disease should the bacteria invade their bloodstream. Children at pre-school or daycare are also at greater risk.

'Once we get older we develop other risk factors. In the case of adolescents it is likely lifestyle factors play a part. Sharing of spit, smoking, drinking, staying up late, perhaps preceding viral infections. We actually have incomplete knowledge about why some people get meningococcal disease, it is an insidious infection,” she says.

Helen says as crowding is a major risk factor for the disease it is recommended that those students heading off to university receive the vaccine.

'Students living in hostel accommodation are one of the groups who are at increased risk of meningococcal disease. This is likely because they are in closer contact with a larger number of people. There is higher carriage of the bug among this group and it is transmitted from person to person through respiratory droplets such as coughs and sneezes,” she says.

There are several different types or serogroups of meningococcal bacteria including groups A, B, C, W and Y, the most common in New Zealand being meningococcal group B with 70 percent of cases caused by this strain in 2016.

Helen says overcrowding and prior respiratory infections could also be key factors in why Maori are disproportionately affected.

'As a parent of a teenager I am considering purchasing a course. We have a great new vaccine that appears broadly protective to combat a really nasty disease.”

Spokesperson for the Meningitis Foundation Aotearoa NZ Andrea Brady says the organisation has been founded to promote the prevention, control and awareness of the disease.

The Foundation works to support families affected by meningitis and in an advocacy role improving access to vaccines.

'One death from meningococcal disease is one too many, particularly when a protective vaccine is available and has been available in other countries around the world for some time.

'If you talk to any family who has experienced meningococcal disease or meningitis they would say that if a vaccine is available and can save another family from experiencing the heartache or heartbreak that they have gone through, there should be no question about its availability.”

Helen says unlike diseases like whooping cough which comes in cycles it is hard to predict when a new outbreak of meningococcal disease may occur and it is always lurking around.

Bexsero has recently been funded as part of a meningococcal B immunisation program for children and young people in South Australia and is funded on the National Immunisation Program for infants in the United Kingdom.

Bexsero is not currently funded on the NZ National Immunisation Schedule, but is available for private purchase through healthcare professionals.

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