I will start off by saying that Meningococcal Meningitis (MM) can be a very nasty disease and it is important to realise that anything that can be done to prevent this disease would be very welcome. However the question of whether vaccines are the answer is greatly debatable. Of course, drug companies/vaccine manufacturers tend to seek for the wrong answers. Since their job is to make profits for their shareholders, they concentrate on a simple solution, such as, making a vaccine. Instead of asking, “What life-style modifications can be made to prevent this nasty illness?”, they ask “Can we develop a vaccine that we can sell for large profit?”
The real fear of MM is that it has a very sudden onset and if treatment is not started at an early stage, death or serious disability will occur. It is not hard to see why this disease makes front page headlines in the newspapers.
Despite all of the above we must put MM into perspective. Figures from Great Britain show that there are 2 peaks of incidence. One is in the under 3 age group and the other in the 15 to 20 age group. In Britain, during the years 1994 to 1995 (i.e. 5 year period) approximately 20 died under age 1, 21 aged 1, 18 aged 2, 15 aged 3 and only a handful of 4,5,6 year olds. After that there were virtually no deaths from MM till the second peak starting at age 15. Here the rates are approximately 12 aged 15, 30 aged 16, 12 aged 17, 18 aged 18, 18 aged 19 and 10 aged 20. This adds up to approximately 200 deaths in 5 years, approximately 40 per year. 40 a year may sound a lot but when you consider the British population of 14 million children and young adults, this gives a rate of approximately 1 in 200,000.The case fatality rate is approximately 10% for MM. That means that of every 100 that develop MM, 10 die, or to look at it from another viewpoint, 90 survive.
The death of any child or young adult is a very tragic event and we must not lose sight of this. However in the proportion of things, 40 a year is a very low number. Is it reasonable to immunise the whole population for a disease with such a low incidence? To put it into proportion, it should be pointed out that a baby is 5 times more likely to drown in a bath tub and 86 times more likely to die of Cot Death than MM. Children and young adults are 32 times more likely to be killed in a motor vehicle than of MM.
So, is MM really an epidemic, or is it a product of media hype. I think it is probably the latter.
The bacteria that causes MM is called Neisseria meningitides and the natural habitat of this organism is in the nasopharynx of man. Surveys of normal populations show that there is carrier rate of 5-10 percent. (Medical Microbiology Cruickshank et al 12th edition 1973)
This means that in a group of 100 people 5-10 have this bacteria in their throat without any problems. We have to ask ourselves why some people can carry the bacteria in their throat without any problems at all and others develop a quickly deteriorating fatal illness.
Louis Pasteur, on his death bed indicated that the problem with infection is not the bacteria but the body. He is reputed to have said that it is the soil not the seed. What would cause a bacteria living happily in the throat of someone to suddenly flare up and kill the person? That is, is it the person who has the bacteria that develops the illness, or do these people cough and sneeze and spit out the bacteria and someone else catches it? (I suppose that the people with the bacteria in the throat can build up immunity to it.) If this is the case then there would be a lot more of the illness around because there is a lot of coughing and sneezing going on. Every day in our lives we meet people, we are in close contact, in buses, in the supermarket, etc but very few get the disease. Again, I go back to Pasteurs utterance, is it the soil or is it the seed. If it is not the seed, what about the soil?
The degradation of the immune system has been going on for many years. Modern society has introduced so many new influences that can suppress the immune system and it is our immune system that keeps us from getting sick. Pollution, chemicals, insecticides, antibiotics and hormones in our food and water, petrochemicals in the air we breathe, the deteriorating quality of our food, the fact that most people eat a relatively very poor diet, children receiving huge numbers of vaccines, people smoking (active and passive), drinking, taking drugs…. all these add up to suppress our immune system. This produces a “soil” that is very conducive to the growth of bacteria. Bacteria do not grow in a clean body with a good immune system. Bacteria grow in toxic bodies with poor immune function.
In the older age group the development of MM is correlated with close, intimate contact, kissing, sharing drinks, etc, though the bacteria is not highly contagious. Even amongst close family members there is only a 1 in 300 chance of contracting the disease (Georgia Dept of Human Resources fact sheet Nov 2000). The bacteria are classified according to antigens found on the outer capsule, designated as A, B, C, etc. Overall, in the USA, the B strain is responsible for 50-55% of cases, the C strain for 20-25% of cases and the W-135 for 15% of cases.
Strain B seems to be more deadly amongst the younger age group, accounting for at least 2/3 of all deaths in this age group. Strain C accounts for approximately 40% of cases.
In the older age group, the C strain seems to be the most dominant accounting for 80% of deaths.
A vaccine against strain B has not yet been developed.
A paper published in Southern Medical Journal 2001;94:1192-4 studied college students who developed MM. They found that the ones who developed MM had partied hard, that is, developed MM after a bout of drinking and smoking. There have been many papers published looking at the link between drinking and smoking at bars and discos and developing MM. Here again, not every one who goes to a disco gets MM. So, what is the reason? Is it the fact that many who do go to these venues and drink and smoke also eat poorly and therefore have a weak, suppressed immune system? Is this life-style one that predisposes to catching MM? It seems to be so. (see J Infec Dis 1998 Jul;178(1):266-9, Epidemiol Infect 1998 Jun;120(3):263-70, J Clin Microbiol 1995 Aug;33(8):2209-11)
Young adults in university are under stress; stress from studies, stress from exams, as well as the partying life-style that many lead. Binge drinking and smoking have been put forward as risk factors for developing MM. There is also poor nutrition and perhaps over-crowding in student accommodation. All these lead to reduction in immune system function.
There are 2 types of Meningococcal vaccine: the polysaccharide and the conjugated.
The polysaccharide vaccine is the older of the two and uses the outer capsule of groups A, C, Y and W135. Note that there is no inclusion of the B type and it is not very effective in children under the age of 2. As noted above babies are more susceptible to the B strain (JAMA 2001 Jan 10;285(2):177-81).
There is a newer vaccine, the so-called conjugate vaccine, similar to the Hib vaccine, where an antigen is conjugated onto another antigen. This is supposed to help stimulate the body to produce a stronger antibody reaction because it is conjugated to a “tried and tested” antigen such as tetanus or Diphtheria. This vaccine only covers strains A and C.
Official company and government sources state that side effects and reactions are uncommon. Virtually in the same breath they say that the benefits outweigh the risks. (Note: this is what they always say and there really is no evidence.) The Observer, a British newspaper has obtained government documents that show more than 16,000 adverse reactions, ranging from headaches and dizziness to vomiting and convulsions, and 12 deaths. When it is known that only about 10-15 percent of reactions are reported, the total number is very much greater and this is a real concern.
The government says that after the vaccination campaign there was an 85% drop in the number of cases of MM. Figures compiled by The Observer shows that the drop was only 18% and in some parts of London there was actually an increase in incidence.
Who can we believe? The government wants to put the best light on the situation. The Observer wants to sell more papers. If the truth is somewhere in between, then that would still be a significant problem indeed.
The British Government instituted a mass vaccination program with the newly developed conjugate vaccine, more than 13 million children were vaccinated. Many parents have complained that the government has ignored their complaints about reactions their children developed after the immunisation.
Another major concern is that many on the Committee on Safety of Medicine board have close financial ties with the companies that manufacture the vaccine. There is a possibility of conflict of interest. The American Academy of Pediatrics (AAP) has released a statement where it is not recommending mass immunisation, only giving it to target groups, or to those that request it. (AAP News July 1998)
WHAT ELSE CAN YOU DO TO PREVENT MM?
Some things have been mentioned already. Good diet, babies need to be breast fed, avoid pollution, keep healthy. College students should also eat well and dont party excessively, dont binge drink and definitely dont smoke. Get plenty of sleep. Use herbs such as Echinacea and take vitamin c supplements.
In Treasis on Homeopathic Medicine by FX Eizayaga (Buenos Aires 1991) a study was described where 18,000 children were given a homeopathic nosode Meningococcinum 11c prior to an epidemic. The result was that none of those children developed MM and none developed any side effects.
In summary, MM IS a nasty illness, though the incidence is relatively low.
Life-style changes can be protective. The vaccine is only partly effective as it does not cover strain B. Side effects of the vaccine do occur and the incidence is not known for sure.
The giving of other vaccines could lower immune function which could predispose you to developing MM.
Having this knowledge will help you to make an informed choice of whether to give the vaccine to yourself or your child. This also applies for any other vaccine or medical intervention.