Meningitis is thankfully rare, but the outbreak in Kent is a cruel reminder that the disease is still with us, and that young people are most at risk.
Health authorities are yet to identify the exact strain that has killed two students – one a sixth-former in Canterbury, the other studying at the University of Kent – and left 11 others seriously ill.
But we know we are dealing with the bacterial form of meningitis. Thankfully, not as common as it once was, but no less devastating.
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“There’s been less and less disease thanks to the effectiveness of vaccines, which are now available on the NHS”, said Dr Tom Nutt, chief executive of charity Meningitis Now.
“So to get a big cluster like this in Canterbury, I think, is pretty shocking and pretty unusual.”
Babies, children and young adults are most at risk, and the bacterial infection – sluggish compared to respiratory viruses like colds and flu – has more chance to spread through the social scene and shared accommodation of colleges and universities.
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The UK Health Security Agency says it has shared information with 30,000 people in the outbreak area.
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Contacts of cases are being traced and offered antibiotics to prevent new infections, reducing the risk that the current outbreak will grow. The risk to anyone outside of the outbreak itself is lower still.
But for those made ill, along with the 300 to 400 people each year in England unlucky enough to get bacterial meningitis, also called meningococcal disease, it’s horrific.
Meningitis causes swelling of the membranes lining the brain and spinal cord, which itself can be life-threatening, as well as the risk of brain or nerve damage in those who recover.
But there’s also a high risk of blood infection, leading to sepsis, once the bacteria crosses the blood-brain barrier.
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Symptoms – which include a high temperature, severe headache, cold hands and feet, a stiff neck, delirium and fatigue – can worsen extremely rapidly.
“When it comes to bacterial meningitis, which is what we’re talking about today, around about one in 10 people affected may die, and the disease can kill people within 24 hours or less”, said Dr Nutt.
Thankfully, vaccination has reduced the burden of meningitis across the board. Babies are offered routine immunisation against meningitis B, the most common strain.
The NHS also vaccinates teenagers, typically in year 9 or 10, with the meningitis ACWY jab that protects against other, less common, but equally dangerous strains.
However, after a huge drop in cases due to less social mixing during the pandemic, meningitis is on the rise again.
Worryingly, vaccination rates have fallen at the same time, particularly among teenagers.
According to UKHSA data, Meningitis ACWY vaccination rates for year 9 students were 88% before the pandemic compared to 72% now.
In the autumn, the UKHSA and campaign groups reminded students headed for college and university to check if they had the vaccine. Catch-up doses are available on the NHS for anyone under 25 who missed their scheduled dose.
Campaigners are also pushing for teenagers and young adults to be offered the meningitis B vaccine. Because it was only introduced a decade ago, there is a “gap” in vaccination coverage for teenagers who would have missed the jab as babies – and protection wanes over time.
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The MenB jab is an expensive jab offered to babies, given they carry the highest risk of illness and death.
Even though the strain involved in the current outbreak hasn’t yet been identified, Dr Nutt says it should serve as a wake-up call.
“We believe that all those most at risk of disease should be given that vaccination on the NHS.”
Vaccine protection isn’t perfect, though, and wanes over time.
Public health officials and charities are reminding those in the affected area, especially young people and their parents, to be vigilant for symptoms of meningitis or sepsis and to call 111 as soon as possible if they are concerned.
