Meningitis B – universal suffering?
Three days after her death on Valentine’s day, Jenny Burdett bravely published pictures of her 2-year-old daughter Faye lying in hospital suffering from the meningococcal B infection that killed her. Since her death, a petition calling for all children to be immunised against the disease has already gained 400,000 signatures.
While we tend to associate meningococcal disease with meningitis – inflammation of the lining of the brain, it also causes septicaemia, or blood poisoning. The rash which doesn’t fade when you press a glass against it, the ‘classic’ blotchy red rash every parent is warned about, is actually a result of septicaemia. This blood poisoning affects the whole body, and can lead to amputations, severe brain damage and sometimes death. Faye’s photo showed her lying in a hospital bed, covered from head to toe in this blotchy rash.
Meningitis B is most common in children under 1 year old, with cases peaking at 5-6 months of age. In September 2015, Public Health England introduced a Meningitis B vaccine into the NHS children’s immunisation programme, with doses given at 2, 4 and 12-13 months old.
Before this immunisation was introduced, Meningitis B was the most common, and most deadly, form of meningococcal disease in the UK – 500-1,700 children a year caught it and 1 in 10 of them died. It accounted for 90% of cases of meningococcal disease in the UK. But this wasn’t always the case. In the past, another strain of meningococcal disease, the C strain caused equal devastation – but the number of cases has dropped by about 95% since a vaccine against this strain was routinely introduced in the UK for children. Since 2013, a campaign to offer a MenC booster vaccine to all 13-15 year-olds, and any under-25s who haven’t had one, has aimed to cut the risk of the disease in older teenagers and students.
There are other causes of meningitis too. Cases of meningitis from Haemophilus influenzae group B (Hib) have dropped by 98% since Hib vaccine was offered to all babies as part of the NHS immunisation programme, and before the introduction of MMR immunisation, mumps was among the commonest causes of meningitis in the UK.
With such dramatic results from previous immunisation campaigns, it’s hardly surprising that so many parents of older children have been trying to get MenB immunisation for their little ones. I’ve felt desperately guilty at not being able to offer immunisation to kids who missed the introduction date by only a few days on the NHS, because they were born too soon. I’ve had to explain to them that their only option was seeing a private doctor and paying for immunisation, because children born more than 2 months before the new vaccine schedule was introduced aren’t eligible for immunisation on the NHS. Now it seems private clinics are running out of vaccine, as desperate parents rush to get their children immunised.
What’s the answer? The obvious one is opening up immunisation to all, at least until the age of 11, on the NHS. But the wheels of the NHS grind slowly – and I, as an NHS GP for 26 years, know that better than most. In the meantime, I shall urge parents to be aware of the warning signs of meningitis – and I’ve signed the petition.
After this article was originally published, Dr Jarvis published a further piece, explaining how and why she was eating her words, as above. Read her new article here.