Call to vaccinate travelers vs deadly bacteria

The annual pilgrimage to Mecca in Saudi Arabia, which draws about 3 million Muslims from around the world, only highlight the importance of getting immunized. Expected to be the largest mass gathering in the world, it provides the ideal condition for the transmission of infectious diseases including meningococcal disease.

While outbreaks of typhoid and cholera have been a usual concern during Hajj, meningococcal disease has become a more recent health threat considering that aside from the fact that outbreaks could quickly spread to immediate contacts, even those with no pilgrim contact are at risk.

Cases of meningococcal disease continue to be identified even three to four months after the Hajj—most likely as a result of pilgrims assimilating into the community and dispersing the bacteria that cause then. This is why the Kingdom of Saudi Arabia now requires pilgrims a certificate of vaccination against meningococcal meningitis.

Meningococcal disease, which is caused by the bacterium Neisseria meningitidis, is transmitted by direct contact and respiratory droplets, and is spread by prolonged or close contact (while traveling on a long-haul plane trip, attending a huge gathering or when living in a dormitory-like community where people are so close to one another).

Potentially fatal disease

“Meningococcal disease is potentially fatal and should always be viewed as a medical emergency,” said Dr. May Montellano, president of the Philippine Foundation for Vaccination. She explained that the disease usually causes the inflammation of the membrane that covers the brain and spinal cord (causing meningitis) as well as blood poisoning (septicemia).

According to Montellano, meningococci bacteria could live naturally in the back of the nose and throat in about 10 percent of the population without causing illness. “This is why when that person, say goes home from the Hajj and comes in contact with a more susceptible member of the household or even neighbor, transmission may occur,” she said.

Moreover, she reminded that meningococcal disease can occur all year round and in all age groups. But while most people who get meningococcal disease get better, 5 to 10 percent could become extremely ill within 24 hours that despite timely and aggressive antibiotic therapy, will not be able to survive.

“Even those who survive often have permanent disability, including brain damage or limb loss (due to necrosis). Even with recovery, some individuals may require long recovery process involving extensive rehabilitation,” the doctor said.

Of the cases reported in 2010 by the Philippine Integrated Disease Surveillance and Response, fatality rate was 50 percent among the age group that included infants (as high as 65 percent was observed), toddlers and children.

Recommended

To decrease the risk of getting infected as well as save one from the expensive antibiotic regimen, vaccination is recommended especially for infants, adolescents, elderly individuals and those whose spleen were removed or no longer functioning (similar in structure to a large lymph node, a spleen acts as a blood filter and fights certain types of bacteria including those that cause meningococcal disease).

The vaccines recommended for pilgrims as well as those traveling to regions where the disease is rampant include Meningococcal (groups A, C, Y and W-135) polysaccharide diphtheria toxoid conjugate vaccine that could be administered to individuals as young as 9 months (although those aged 9 to 23 months may need a second booster shot).

The vaccine is more preferred considering it is given only once and those aged 2 and older no longer require a second booster shot.

“Getting vaccinated is recommended considering that early signs and symptoms are non-specific and thus, be easily misdiagnosed in its early stages, even by experienced healthcare professionals,” said Dr. Ruby Mendoza-Dizon, medical director of Sanofi Pasteur.

Aside from fever and headache, symptoms may include extreme fatigue, sensitivity to light and vomiting or shivering, muscle or joint pain as well as rash that could later turn into red-purple bruise-like blotches.

“If somebody close to you has some of these signs and symptoms and seems much sicker than you would expect with a normal infection seek medical help immediately since only a thorough laboratory test could confirm this particular disease,” Montellano said.