Russian epidemiologists warn of a possible outbreak of bacterial meningitis

Russian epidemiologists see every sign that an outbreak of bacterial meningitis is about to begin in the country – terrible infections that cause brain damage, with a mortality rate of up to 20% and a high probability of remaining disabled for the rest of your life. After the pandemic, the incidence of bacterial meningitis went up, and several outbreaks have already been recorded in the country, including in Moscow and the Moscow region. If the situation is not taken under control, it can become unmanageable. Experts announced this during the XV annual All-Russian Congress on Infectious Diseases named after Academician V.I. Pokrovsky.

Meningitis is a serious infectious disease that causes inflammation of the lining of the brain and spinal cord. There are three main types of meningitis: bacterial, viral and fungal. And if the viral and fungal types of meningitis are not so life-threatening, then bacterial meningitis is the most common and dangerous of those listed. In most cases, it is caused by meningococcal and pneumococcal infections, as well as Haemophilus influenzae.

The disease begins as SARS – with fever, headache, sensitivity to light. And often in the early stages of the disease, patients (or their parents) do not understand that they need to urgently seek medical help. Given that meningitis develops rapidly, and its last stages of development are deadly, such a delay can be fatal.

According to statistics, about 1-1.2 million people fall ill with meningitis every year, on average 300 thousand of them die due to the rapid development of the disease, and every fourth ill person becomes disabled or has irreversible health complications (loss of hearing, vision, amputation of limbs, neurological disorders). Meningitis is especially dangerous for those who have a weakened immune system. First of all, this applies to children under five years of age – their immune system is not yet fully formed and cannot fully fight certain types of infections.

Some countries around the world have calculated how much this disease costs. For example, the cost of the consequences of the disease for a patient from France, who was ill in childhood and lost both legs, until the end of his life (77 years) amounted to 1.4 million euros. But the medical expenses for a woman who had an illness at the age of 3, received severe neurological consequences and died at 55 years old, amounted to 4 million euros: this included expenses for care, hospital care, specialized equipment, etc. In Russia, such calculations were not conducted.

According to Irina Koroleva, head of the Reference Center for Monitoring Bacterial Meningitis, Head of the Laboratory of Epidemiology of Meningococcal Infection and Purulent Bacterial Meningitis of the Central Research Institute of Epidemiology, mortality in bacterial meningitis ranges from 4 to 20%, depending on the strain and age of the patient: “In recent years, the spread in world have received hypervirulent strains, among them a Chinese strain and a strain from the US At the same time, we are faced with difficulties in choosing a drug for treatment: there is an increase in bacterial resistance to antibiotics, including penicillin. environment and change. Scientists consider the bacterium that causes meningitis to be one of the most variable in nature.”

In recent years, the incidence of bacterial meningitis has gradually decreased, and during the pandemic it even began to descend to minimal levels. But epidemiologists explain this, first of all, by lockdowns and strict sanitary standards, which have led to a decrease in the spread of many infections. But the periods of isolation are over – and in the last year there has been a sharp rise – it has doubled. Growth was recorded in all federal districts, except for the Far East. Among adults, the growth was 1.4 times, among children – 2.1 times.

“Another new feature that we haven’t seen before is the appearance of foci with group morbidity. In 2022, the outbreak was in Novosibirsk: 62 people fell ill in 2.5 months, the population had to be vaccinated on a large scale. And in Moscow in 2022 there were 7 foci : mostly men, visitors from Uzbekistan, were infected.Following Moscow, there was an outbreak in the Moscow region (Istra district): 7 people fell ill with meningococcal meningitis, 1 was fatal. !” – continues Irina Koroleva.

Epidemiologists state: in the Russian Federation, all signs of a complication of the epidemiological situation have been identified. This is a general increase in the incidence, an increase in the incidence in adults, the occurrence of foci of infection, the predominance of one pathogen. “All this may indicate the beginning of the rise. For many years we lived in the inter-epidemic period, but now we see signs that it is ending. We must be vigilant,” Koroleva warns.

Today, bacterial meningitis can be prevented by vaccination; there are vaccines against all pathogens of purulent meningitis (pneumococcus, meningococcus, and Haemophilus influenzae). But in general, epidemiologists call the coverage of these vaccinations of the Russian population “unacceptably small.” For example, in Moscow there is a program for compulsory vaccination against meningitis for migrants. Epidemiologists believe that all these vaccinations should be in the all-Russian calendar.

In the world, for example, vaccines against Haemophilus influenzae have been introduced everywhere, except for China. And if about them (in the 70s of the last century) 45 cases per 100 thousand children were recorded, now in the USA – 0.3 per 100 thousand, and in Europe – 0.29 per 100 thousand, in Japan there are there has been no meningitis since 2014 at all. The incidence of hemophilic meningitis in the Russian Federation does not tend to decrease, experts say.