Fight against meningitis lags behind other preventable diseases

The fight against meningitis is lagging behind progress made against other vaccine-preventable diseases, a study has warned. 

There were over 2.8 million cases of meningitis in 2016 and nearly 320,000 people died from the disease - a 21 per cent reduction since 1990 - according to analysis published in The Lancet Neurology.

But while this reduction is positive, it pales in comparison to progress made against other vaccine-preventable illnesses: deaths caused by measles, tetanus and diarrhoea have dropped by 93 per cent, 90 per cent and 58 per cent respectively over the same period. 

Meningitis is the inflammation of the meninges - the protective membranes around the brain and spinal cord - and although it can affect anyone it is most common among babies, children and adolescents.

If it is not recognised quickly, it can result in permanent deafness, blindness, brain damage or, in the worst cases, death. 

In the UK meningitis is predominantly associated with university students, but the disease is most prominent in sub-Saharan Africa in the “meningitis belt," with the burden highest in South Sudan.

In the region, meningitis outbreaks are seasonal, taking place between November and March when dry winds strip the lining on the back of people's nose and throat - making it easier for bacteria to enter. 

“Meningitis is one of these diseases that doesn’t gain much attention,” said Claire Wright, researcher at the Meningitis Research Foundation (MRF). “This is starting to change, but in the UK we aren’t really aware of the global burden.”

There are many strains of the disease, but the three main pathogens - Haemophilus influenzae type b, Neisseria meningitidis (meningococcal), and Streptococcus pneumoniae (pneumococcal) - are largely responsible for endemic and epidemic meningitis around the world.

All three of these strains are vaccine-preventable. But despite significant successes - meningococcal cases have dropped by 99 per cent in the "meningitis belt" thanks to the MenAfriVac vaccination programme - the Lancet study suggests that efforts to control the disease worldwide have come up short.

Ms Wright said progress was stilted in part because vaccinations do not cover all forms of meningitis. 

"The pneumococcal vaccine is limited, for example, because it only protects 10 of the 13 types of meningitis," Ms Wright said. "So you can't just give one meningitis vaccination targeting against all strains." 

But while developing an affordable, universal vaccine will be key to defeating the disease, it is just one part of the puzzle. 

"We also need to get a rapid diagnostic test to identify meningitis," said Ms Wright. "Meningitis can be easily confused with other illnesses, including malaria, and currently doctors have to take a sample of fluid from the brain and spinal cord to identify it." 

This process is not only invasive and expensive, but there is a shortage of trained medical professionals who can perform the procedure. 

The report also says that ongoing surveillance of the specific types of bacteria causing meningitis will be crucial to monitor meningitis trends across the globe.  

“Meningitis spreads around the world and we need a coordinated effort to defeat it. We need faster progress, similar to that achieved with measles, tetanus, and diarrhoea," said study author Linda Glennie from MRF.

Earlier this year the World Health Organization launched an expert taskforce to develop a plan to defeat meningitis by 2030.

"This taskforce is a crucial step towards defeating meningitis for good,” she added.

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