Amid all the bad press about vaccination, it is nice to be able to report a success story on which scientists, doctors and patients agree, writes Dr Muiris Houston.
A vaccination programme against meningitis C was introduced in the Republic in October 2000. Within a year it has led to a 75 per cent reduction in cases, from 139 in 2000 to 35 in 2001, according to the latest statistics from the National Disease Surveillance Centre.
Meningitis is a killer disease, and the Republic has had one of the highest attack rates in Europe. Meningococcal infection caused more than 80 per cent of cases of bacterial meningitis and septicaemia last year. There are a number of subtypes of the meningococcal bug, including A, B, C, 29E, W-135, X, Y and Z.
Recent statistics show type B as the cause in 60 per cent of cases, with almost 40 per cent due to type C; the others occur very rarely in this part of the world.
The Republic's growing Muslim population needs to be aware that outbreaks of group W-135 disease have occurred over the past two years among visitors to Mecca on the hajj pilgrimage. And intrepid travellers are at risk of group-A meningococcal disease in sub-Saharan Africa, Nepal, Pakistan and parts of India.
But back home, the most striking reductions were seen in the age groups targeted by the meningitis C vaccine programme, ranging from a 93 per cent reduction in five- to nine-year-olds to a 70 per cent reduction in the 10-14 age group. (See table 1.)
There was also a reduction in the number of deaths from bacterial meningitis last year. In 2000, 25 people died from meningococcal disease, 11 of them from meningococcal C. Figures for last year show the overall number of deaths to have more than halved, to 11, only three of which were caused by the C strain of the bacterium.
The vaccination programme initially targeted babies coming for their primary immunisations at two, four and six months and for their MMR - measles, mumps and rubella - vaccine at 15 months. Secondary-school students from Junior to Leaving Certificate were also part of phase one, as were first-year third-level students.
Phase two of the programme targeted children aged up to six. Now, the Office for Health Gain has launched the final phase, aimed at young adults from 19 to 22.
A single dose of the vaccine gives protection to children over a year old and to adults. Babies require three doses, given at least a month apart.
The meningitis C vaccine is not live, which means it is extremely safe. It is incapable of causing even a mild case of meningitis or septicaemia.
More than a million doses have now been administered here, with a low rate of adverse reaction, such as redness or swelling at the injection site or a mild temperature. Older children and young adults sometimes complain of headaches, dizziness and swollen glands. Such reactions are generally not serious, and they disappear fast.
As with any form of medicine, there is a theoretical risk of a serious allergic reaction to the shot. There have been no fatal reactions, with just one severe allergic reaction reported for every half million doses of vaccine.
No vaccine is 100 per cent effective, but the figures for meningitis C failure are impressively low. There has been a single case in the Republic of meningitis C in an immunised person, and it did not progress to septicaemia; the victim made a full recovery, suggesting the vaccine at least helped to ameliorate the disease.
Dr Darina O'Flanagan, director of the National Disease Surveillance Centre, says: "The programme has been very successful. It has saved the lives of eight children and prevented the admission to hospital of over 100 others."
Unfortunately, although clinical trials are under way, there is no sign of a marketable vaccine for meningitis B within the next five years. So it is extremely important to remain vigilant for the symptoms of meningitis and septicaemia caused by other types of meningococcus. (See table 2.)
Meanwhile, all 19- to 22-year-olds - 25 per cent of whom carry the bug in their nasal cavities - should make an appointment with their GPs or student health services to get the meningitis C vaccine. It could save their lives.
The Meningitis Research Foundation has designated February meningitis-awareness month. Its campaign will feature microscope pins available, for a donation of €2, from all Boots stores, the proceeds of which will go to research into the disease. The pins are attached to a card that outlines the prominent symptoms of meningitis. The foundation's 24-hour helpline is at 1890-413344.
E-mail Dr Muiris Houston, Medical Correspondent, at mhouston@irish-times.ie or leave a message at 01-6707711 ext 8511. He regrets he cannot reply to individual medical problems