Meningitis B in KFL&A: here’s what you need to know

Neisseria meningitidis bacteria occasionally invade the body and cause meningococcal infection, which is an acute severe bacterial infection. Image via European Centre for Disease Prevention and Control (ECDC).

An increase in patients seeking a vaccine for meningitis B has led to concerns in the community about the shot’s availability and cost. Reached for comment, Dr. Piotr Oglaza, Medical Officer of Health for Kingston, Frontenac, Lennox & Addington (KFL&A) Public Health gave assurance that there is no reason to panic.

According to a public health release, on Thursday, Feb. 29, 2024, Kingstonist reported three confirmed cases of invasive meningococcal disease (type B) in the KFL&A area. In that announcement, KFL&A Public Health explained that invasive meningococcal disease is a rare but potentially life-threatening bacterial infection, and all meningococcal infections are medical emergencies. 

Because meningococcal B is not included in routine vaccinations in Ontario, Public Health advised, “As we continue to work with partners to investigate, we encourage residents 25 years of age and under to ensure they are up-to-date with routine meningococcal vaccines. Individuals who do not meet the high-risk criteria for meningococcal B vaccine are encouraged to contact their health-care provider to consider privately purchased immunization against meningococcal B.”

In the wake of that announcement, Kingstonist received reports from people who found purchasing private immunizations cumbersome and expensive. In an interview on Friday, Mar. 8, 2024, Oglaza responded to these concerns.

He explained that historically, most cases of meningitis were caused by the Type C strain of the bacteria, which led to the meningococcal C vaccine being routinely given at one year of age and the meningococcal ACYW-135 vaccine being administered in Grade 7.

Because of the preventative vaccine, meningococcal A, C, Y, and W cases have become nearly non-existent in Ontario. Oglaza explained that since, historically, meningococcal C and the other types were far more likely to impact the population, vaccines for these types were included in publicly funded immunization programs. 

Meningitis B, on the other hand, “was relatively rare,” so it has never been included in publicly funded vaccination programs. But now, Oglaza explained, because the others have been all but eliminated by vaccines, meningitis B is the type that’s most often seen, though still exceedingly rare.

KFL&A Public Health investigates any cases of meningitis closely to see if they are related, Oglaza explained, confirming that all three of the infected individuals have since recovered and seem not to have any connection to one another. “But… it is still unusual to see this many cases in a situation where we haven’t had one since 2013.”

“Herein lies the problem,” he continued. “When we’re looking at rare events… it is always a question: is that a sign of something going on? Is there increased community activity?… Or is it just an unfortunate coincidence that these three cases showed up independently? That’s the part of the investigation and analysis that we have been doing with… the Ministry of Health and Health Ontario.”

Oglaza noted again that KFL&A Public Health and its provincial partners have not seen any evidence of a connection between the three cases. “While we are in that process of extended monitoring… I believe the community needs to know that we are looking at it, that we are exploring all possibilities, and that we are providing information on what people can do to protect themselves.”

One of the suggested precautions in the release was for concerned individuals younger than 25 to seek privately purchased vaccination against meningitis B, Oglaza said. “But I want to reassure individuals that if the situation changes, if there are more cases in a particular population, let’s say in a school, that changes the parameters. Under those new parameters, everyone who has been a contact with a case in that defined population would be considered to be part of an outbreak and will receive that vaccine free of charge — publicly funded.”

“The province and we are monitoring this closely. That could change in the future, but in the interim, those who either have specific health conditions that make them more susceptible to invasive meningococcal disease or those who are in the populations that are potentially in an outbreak scenario would get all of the doses free of charge,” Oglaza stated.

The main thing the Medical Officer of Health wanted to emphasize was “that invasive meningococcal disease is a medical emergency.” Meningitis often begins “in a relatively mild fashion and resembles an upper respiratory infection.”

Some people might even go to see a doctor and be sent home. Oglaza emphasized that it is important to heed what medical professionals often say: “If there are any worsening symptoms, go to the ER.”

“There’s no way to predict whether it’s genuinely just an upper respiratory disease or [if it is] the beginning of the invasive meningococcal disease… So if there is a severe headache, sudden fever, stiff neck, nausea, vomiting, and a rash, that’s the time to go back to seek medical attention. Don’t wait… Contact a medical professional… because that condition can progress quickly. It requires urgent, emergency medical intervention.”

He also wanted to underscore an important point about immunization cards: “On individuals’ yellow immunization cards, they may see the meningococcal vaccine checked off. But that does not refer to meningococcal B, a very distinct vaccine from the others that are given as part of routine immunization… When in doubt, talk to your health-care provider.”

For more information about invasive meningococcal disease and vaccination, visit the KFL&A Public Health website’s ‘invasive meningococcal disease’ information page.

According to Health Canada, meningitis is an inflammation of the meninges (the lining of the brain and spinal cord). Many types of meningitis exist, and viruses, bacteria, fungi, or other organisms can cause it.

Invasive meningococcal disease is a serious bacterial infection caused by the bacterium Neisseria meningitidis. Invasive meningococcal disease is found worldwide. In Canada, infection often happens during the winter and spring months. Canada has an average of fewer than 200 cases per year.

Symptoms of invasive meningococcal disease occur between two and 10 days after exposure, most typically between three and four days. Severe cases may lead to death. People can be carriers of the bacteria without knowing it. The risk is that it could become invasive or be passed on to children and others who are not immunized.

IMD symptoms can include:

  • sudden fever
  • intense headache
  • stiff neck
  • nausea
  • vomiting
  • sensitivity to light
  • purplish skin rash

According to Oglaza, “It’s important to recognize the signs and symptoms of meningococcal disease and seek medical care immediately if illness is suspected.”

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