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Saturday, 8 February, 2003, 15:52 GMT
Meningitis: prevention
Meningococcal meningitis is now the biggest killer of children aged under four - but mass vaccination may reduce that threat.

What is the scale of the problem?

In the late 1990s, the number of cases of meningitis reported annually had risen to well over 2,000 a year, with the young particularly hard hit.

The Public Health Laboratory Service said part of the reason for the increase might have been growing awareness about the disease.

The subsequent vaccination programme for the "C" strain of the virus has reduced those numbers, but there are still plenty of "B" infections each winter.

The Meningitis Research Foundation (MRF) says the disease is cyclical and upsurges occur every 10 to 15 years.

A rise was forecast for the mid-1990s, but the increase seen in the UK was bigger than anticipated.

"We have the highest incidence now that we have had in 50 years," said a spokeswoman.

Meningitis is an infection that can affect the brain and blood. Initial symptoms mimic those of flu.

Although the disease can kill within hours, the vast majority of patients survive.

Are vaccines available?

The rise in cases has focused attention on preventive measures.

There is currently no vaccination which covers all types of meningococcal meningitis and some that do exist are not effective in all groups of people.

There are three main strains of meningococcal meningitis - A, B and C.

The A strain is rare in the UK, but has caused a large number of deaths in some parts of the world, particularly sub-Saharan Africa where it has reached epidemic proportions.

A vaccine exists for this strain of the disease, but it is not effective for young children - the age group most at risk - and it only lasts for three to five years in adults.

The government announced the introduction of a vaccination programme for the C strain of the disease in 1998 after successful trials on more than 4,000 British children and 21,000 youngsters outside the UK.

The new vaccine was initially be targeted at those most at risk, but has now been extended to a wider range of young babies, and other age groups.

The B strain accounts for 60% of British cases and kills 200 Britons a year - it is far harder to find a vaccine to this strain because there are a number of different types of meningitis B circulating in the UK.

All of these appear different to the body's immune system, so it is hard to find a vaccine which will produce a response regardless of the type encountered.

The MRF is investing 3m in research into the strain. More than half of the money is going towards research into a vaccine.

"If we had more money, we would find a vaccine sooner," said a spokeswoman.

There is, however, an effective vaccine for haemophilus influenzae B meningitis - another form of bacterial meningitis.

This has led to the virtual eradication of Hib meningitis.

Have there been any vaccine successes?

British scientists are also investigating the effectiveness of a Cuban vaccine.

Cuba is the only country in the world to have a national meningitis vaccination programme.

Its development followed a large number of cases, particularly among children, in the 1980s.

The Cuban authorities say that since the vaccination programme began, no children have died from meningitis B in Cuba.

However, there are fewer types of B virus circulating in Cuba, making it easier to produce a single vaccine.

Linda Glennie, medical officer of the MRF
Linda Glennie of the MRF on meningitis
See also:

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08 Dec 98 | Health
09 Mar 99 | Medical notes
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