Influenza and meningitis are intimately linked. Each epidemic of influenza corresponds, with a delay of a few weeks, an increase of episodes of meningitis. The solution ? The vaccine from 12 months up to 24 years old. Professor Antoine Bourrillon, head of the General Pediatrics Department at Robert Debré Hospital in Paris, sheds light on the subject.
What are the risks of meningitis C?
- In 20 to 25% of cases, the meningitis of the child is of bacterial origin. Three bacteria can be incriminated: haemophilus influenzae b (rare since the generalized vaccination), the pneumococcus and the meningococcus, in particular that of the group C. In the majority of the cases, the presence of the meningococcus in the nose and throat does not trigger of illness. But sometimes, meningococcus C passes into the blood, causing serious diseases such as meningitis or sepsis. The first is the infection of the fluid enveloping the brain and spinal cord. The second is characterized by a generalized infection of the blood, due to the spread of meningococcus C in the body.
- Meningitis and sepsis are formidable, especially as the second is complicated, in 1 case out of 3, purpura fulminans. This is the biggest fear of doctors. In the presence of red spots on the skin, associate fever and loss of consciousness that make the severity of the disease. Sequelae can be very serious.
How does the child get infected?
- Meningococcus is a germ with a human reservoir. Teenagers and young adults are the main carriers of this bacteria. They can pass it on to infants and young children. The risk of transmission mainly occurs during direct, repeated and close contact with contaminated saliva. It is even higher in the places of communities (nursery, school) and during the winter period.
What are the signs of meningitis C?
- In children over 3 years, the signs are almost similar to those of adults: high fever, headache, vomiting, stiff neck. In infants, the diagnosis remains more delicate. The child is whiny, refuses arms, has inconsolable crying. The neck may not be rigid. For babies under 8 months, a clue puts on the way: the anterior fontanel is sometimes a little bulging.
What is the indicated treatment?
- Once the diagnosis of meningitis C is made, antibiotic therapy should begin as soon as possible. Its effectiveness is quickly verified by the disappearance of the fever and the return to a normal neurological examination. The treatment lasts at least five days and is done in hospital. All persons close to the sick child receive preventive treatment with antibiotics.
At what age can we vaccinate against meningitis C?
- Since 2009, the High Council for Public Health has adopted new provisions regarding vaccination against meningitis C. From now on, routine vaccination of infants aged 12 to 24 months with a single dose is recommended. With a catch-up for all others, and up to 24 years old. The decline we have on this vaccine is excellent. It has been shown to be effective in the field with a 90% decrease in meningococcal infections. Nevertheless, the vaccination rate remains low and insufficient to ensure correct protection. It is important to understand that this vaccine reduces the number of meningococcal C infections and protects all those who are not vaccinated. In particular infants under 1 year, particularly vulnerable and not targeted by the recommendations.
In times of flu, should parents be more vigilant?
- Yes, especially since the influenza-meningitis association is well established. Each epidemic of influenza corresponds, with a lag of a few weeks, an increase in episodes of meningitis C and septicemia. In the same way, it is observed that the purpura fulminans are soaring.
Interviewed by Maryse Damiens.