Meningitis is a serious infection of the meninges, which are the membranes covering the brain and spinal cord. It is a devastating disease and remains a major public health challenge, according to the World Health Organization (WHO). The disease can be caused by many different pathogens including bacteria, fungi, or viruses, but the highest global burden is seen with bacterial meningitis.
Bacterial meningitis can cause epidemics, lead to death within 24 hours, and leave one in five patients with lifelong after-effects including hearing loss; seizures; limb weakness; difficulties with vision, speech, language, memory, and communication; as well as scarring and limb amputations after sepsis.
Cases of meningitis in the country and deaths due to the disease increased slightly this year, revealed Dr. Jo Janette de la Calzada, pediatric neurologist and vice-president of the Cebu Neuroscience Society. She cited Department of Health (DoH) data showing 2,324 reported cases of meningitis from Jan. 1 to Aug. 12, 2022 compared to 2,574 cases for the same period this year (which is an 11% increase). There were 168 deaths due to meningitis in 2022 compared to 218 this year (a 30% increase). The incidence rate of meningitis was 2.11 per 100,000 population in 2022 compared to 2.33 this year.
The bacteria that cause meningitis are transmitted from person-to-person through droplets of respiratory or throat secretions from carriers. Close and prolonged contact — such as kissing, sneezing or coughing on someone, or living in close quarters with an infected person, facilitates the spread of the disease.
“We are coming out of the COVID-19 pandemic, so people are going out and interacting and exposing ourselves to microbes. This is the reason why the numbers are rising,” Dr. De la Calzada said during the recent webinar, “Isang Pilipinas Laban Sa Meningitis, Handa Ka Na Ba?” (One Philippines in the fight against meningitis, are you ready?).
Organized by the Philippine Foundation of Vaccination (PFV), the DoH, and the Pharmaceutical and Healthcare Association of the Philippines (PHAP) with member MSD, the webinar was held in observance of World Meningitis Day on Oct. 5 with the aim of increasing awareness on meningitis as a vaccine-preventable disease.
The most common symptoms of meningitis are a stiff neck, high fever, sensitivity to light, confusion, headaches, and vomiting.
However, Dr. Dela Calzada pointed out that babies may exhibit different symptoms. These include no wet diapers for 12 hours (due to dehydration); a tense, bulging fontanelle; poor appetite and vomiting; an unusual cry or moaning; sleeping more than usual; pale, blotchy skin; spots or rashes; convulsions or seizures; rapid breathing or grunting; fever, cold hands and feet; and irritability (the baby does not want to be touched). Individuals with these symptoms should be brought to the nearest hospital immediately, and the appropriate antibiotic treatment of bacterial meningitis must be started as soon as possible.
Many cases of and deaths from meningitis are vaccine preventable. Vaccines offer the best protection against common types of bacterial meningitis. They can prevent meningitis caused by meningococcus, pneumococcus, and haemophilus influenzae type b (Hib).
Vaccines reduce the incidence of both antibiotic-resistant and antibiotic-susceptible meningitis infections, thereby also decreasing antibiotic administration and consequently reducing treatment costs and antibiotic-related adverse effects, according to Dr. Marimel Pagcatipunan, chairperson of the Immunization Committee, Pediatric Infectious Disease Society of the Philippines (PIDSP).
While investing in the development of new antibiotics is important, vaccines can be an additional tool in addressing antimicrobial resistance. Vaccination against a bacterial infection can reduce transmission of drug-resistant and susceptible strains in vaccinated populations and, indirectly, in unvaccinated populations through herd immunity.
Dr. Pagcatipunan cited the introduction of pneumococcal conjugate vaccine (PCV) for children in the US which resulted in an 84% reduction in invasive disease caused by the drug-resistant bacteria Streptococcus pneumoniae as specifically targeted by the vaccine in children under two years of age.
She also cited the childhood pneumococcal vaccination program implemented in England and Wales from 2000 to 2016 which reduced the incidence of IPD, including pneumococcal meningitis, across all age groups through a combination of direct and herd protection. Over 700 cases of pneumococcal meningitis were estimated to have been prevented during the first decade of the program.
Progress in defeating meningitis lags that for other vaccine-preventable diseases. This is why the WHO has developed a global plan to dramatically improve meningitis prevention, diagnosis and treatment, disease monitoring, health advocacy, support and aftercare. Turning the WHO’s Global Road Map to Defeat Meningitis by 2030 into reality could save more than 200,000 lives annually and significantly reduce disabilities caused by vaccine-preventable meningitis.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines (PHAP). PHAP represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.
