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Meningitis: Increase in meningococcal W disease in Europe
Meningococcal diseases are currently extremely rare in Germany. Nevertheless, there are always deaths due to the dangerous germs in this country. In addition, experts are now pointing out that there has been an increase in meningococcal W infections in European countries for some time. These can often be fatal.
Bacteria are usually transmitted by droplet infection
Meningococci are bacteria that settle in the nasopharynx of humans and, according to the Robert Koch Institute (RKI), can be detected there in about ten percent of the population without any clinical symptoms. They are most commonly transmitted by droplet infection. When talking, coughing or sneezing, the bacteria escape into the air in small droplets from the nasopharynx and can be inhaled from a short distance. Among other things, the pathogens can lead to bacterial meningitis. This is rare, but dangerous. For some time now, meningococcal infections have been caused in Europe by a serotype that was previously mainly known from Africa.
Increase in infections caused by serotype W
As the CRM Center for Travel Medicine explains in a message, meningococci of the type Neisseria meningitidis - the causative agents of dangerous meningitis - occur worldwide in twelve different serotypes.
In Europe, serotypes B and C traditionally prevail. A few years ago, serotype A dominated in the so-called meningitis belt in sub-Saharan Africa, but type W now predominates.
For some time now there has been an increase in infections caused by serotype W in various European countries such as the Netherlands and England.
According to the experts, “MenW” is one of the meningococcal infections that are most often fatal.
The CRM Center for Travel Medicine advises travelers, especially exchange students and students, who should have the most comprehensive possible vaccination against meningococci. The institute recommends immune protection against all currently preventable serogroups A, B, C, W and Y.
Type B and C meningococci are particularly common in Germany
According to the information in the Netherlands, 57 people had type W meningitis in the first five months of this year, eleven died from the infection.
This means that the number of infections caused by this type of pathogen is already above the - also strikingly high - total number in 2017.
In response to this increase, the Dutch government decided in the past year to have vaccinations to protect young children and elementary school children with a combination vaccine against the A, C, W and Y serotypes.
"In England, where an increase in this serotype was noticeable a few years ago, the quadruple vaccine was included in the state vaccination program two and a half years ago," explains Professor Tomas Jelinek, scientific director of CRM.
There he replaced the single vaccine against type C meningococci. In Germany, only vaccination against type C meningococci is still planned in the vaccination calendar of the Standing Vaccination Commission (STIKO).
In this country, meningococci of type B and C are particularly common. The incidence has decreased since 2003. In 2017, the Robert Koch Institute (RKI) registered 288 cases; more than 70 percent were infections with meningococcal B.
Infection often leads to blood poisoning or meningitis
Meningococci are transmitted by droplet infection and can basically cause two different clinical pictures:
The eponymous meningitis (meningitis) and blood poisoning (sepsis), which can also occur together. "Both diseases develop extremely quickly and can be fatal," says Jelinek.
Therefore, a doctor should be consulted as soon as possible and antibiotic treatment initiated.
It is problematic that the typical symptoms such as fever, fatigue and nausea are rather unspecific and can resemble a flu or severe cold.
"Alarm signals for meningitis are stiff neck, strong sensitivity to light and sometimes seizures," explains Jelinek.
On the other hand, sepsis is noticeable with body aches, rapid, shallow breathing and pale, blotchy skin. The spots are caused by small bleeding and, unlike a normal rash, cannot be "pushed away".
A meningococcal infection can be fatal despite medical treatment. For example, an eight-year-old child died of the disease in Hessen a few months ago.
In addition, some survivors struggle with long-term effects such as deafness, poor learning, or other cognitive problems.
Infections in every age
According to the experts, meningococcal infections can occur at any age, but are particularly common in two age groups: mostly children in the 1st and 2nd year of life and adolescents aged 15 to 19 are affected.
Beyond the age of 25, the disease tends to be rare unless there are special risk factors.
"The incubation period is usually 3 to 4 days, but it can also be between 2 and 10 days," writes the RKI.
Comprehensive vaccination protection, especially for younger travelers
The CRM Center for Travel Medicine advises younger travelers, in particular, that they should have the greatest possible protection against vaccination against meningococci.
The institute recommends immune protection against all currently preventable serogroups A, B, C, W and Y.
This is particularly important for travelers up to the age of 25, especially if they have close contact with the local population or spend the night in shared accommodation.
This particularly affects exchange students. The risk of contracting meningococci is particularly high in this group. (ad)