Saving Lives

As people in this island have been learning increasingly over the past decade, bacterial meningitis can spread great fear in …

As people in this island have been learning increasingly over the past decade, bacterial meningitis can spread great fear in communities where single cases or small outbreaks occur. The fear is justified because of the propensity for meningococcal infections to produce a lethal septicaemia in which bacterial toxins surge through the blood and organs of the body in a manner which can produce death within hours of the appearance of the first signs of the disease. But the fear can also prove helpful if it alerts parents to watch for the signs and symptoms of the disease in order to get skilled medical attention immediately, because early medical intervention can save lives. In fact there is some indication that in this State we may be doing better than elsewhere insofar as last year's statistics indicate that there were 447 cases of meningitis here, only 21 of which resulted in death. The more widely reported norm is a mortality rate of the order of 10 per cent: the United Kingdom reported 1,500 cases of infection by the C strain of meningococcus with 150 deaths in that number.

Clearly, effective prevention is better than attempted cure. This week's announcements in both the UK and here that there is soon to be available a safe and effective vaccine against Group C meningococcal infections is good news because it is bound to save lives, and particularly young lives, in significant numbers. But, especially in the UK where the announcement was delivered across the front pages of many newspapers with noticeable hyperbole, the availability of this vaccine cannot be allowed to lull the fear among parents, teachers and health personnel which an outbreak of bacterial meningitis has rightly stimulated. The fact is that the C strain of meningococcus causes fewer than half of all cases of bacterial meningitis which occur each year. With up to two thirds of such cases being caused by the B strain of the bacterium, against which there is still no vaccine available, the stimulus of fear will still be required to alert people to watch for the earliest possible signs of the disease.

There has been a vaccine available against the Cstrain of meningitis for some years past, but it has not proved wholly effective and has not been routinely available. The new vaccine appears not only to be safe but to be better in the promotion of a longer and more effective resistance of infection among those who receive it. It has been tested in 4,500 British children and in about 20,000 children outside the UK - mostly in America - and has been in use in certain American states since last year. It appears to initiate an antibody response in the body which effectively kills the C strain meningococcal bacteria before they can trigger sickening or fatal disorders. It is thus likely, if administered around the time when infants receive their immunisations against other serious infectious diseases, to reduce the overall number of cases of bacterial meningitis.

The Department of Health has said it will be introduced into current State immunisation programmes as soon as it becomes available here. The UK Ministry has said that it plans to start using it in October. The sooner the better, as long as it is not allowed to have the effect of impairing the current alarm systems that swing into place whenever cases of meningitis occur. The earliest medical intervention is still the only weapon we have for saving lives when the case is caused by the B strain of the bacterium.