Meningococcus bacteria are the cause of this disease, in addition to pneumonia, which can lead to death, infectologists say.
The meningitis or meningococcal disease It is an infection caused by a bacterium that in Central America is not a disease as frequent as in South American or African countries, but when it appears it is a devastating disease, which causes a lot of impact on the population, says Dr. Lourdes Dueñas, an infectious pediatrician .
In El Salvador, according to Health data, in the consolidated until December 14 of this year, there are 5 suspected cases of meningitis reported.
The cases were in the age groups of children under one year old, from 5 to 9 years old, adults between 20 and 29 years old, and between 50 and 59 years old.
The departments where the disease is reported were Santa Ana, La Libertad, San Salvador and Cabañas.
Pneumococcal disease causes 170,000 deaths a year in the world, and the diseases it transmits are meningitis, meningococcemia, which is the presence of the bacteria in the blood; pneumonia; In addition, it can give infections in the heart such as myocarditis and even arthritis, otitis and mumps.
“This disease has a 50% mortality rate, depending on the type of the disease, which cause significant and disabling sequelae,” explains the infectologist.
In El Salvador, in September 2017, there was a very common case of meningitis in a child under 10 years that caused alarm in the population, since there was talk of an alert for the disease.
In the cases registered that year, the Health authorities reported that there were 7 nationwide and that there had not been an outbreak of meningitis.
Rolando Masis, director of Health Surveillance of the Ministry of Health in the previous management, reported that the case of the minor had not been considered meningococcus, which is the one that would have worried them because they may have epidemic potential.
In Central America, the exact number of cases for meningococcus is not established because there is no single surveillance system but several. That is because some countries report confirmed cases, in others suspicious cases and others cases under study, although it is a mandatory reporting disease, therefore there is an incidence of the underestimated disease, said Dueñas.
Meningococcus bacteria
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“Panama registered 24 cases for 2018, El Salvador records 12 cases and Costa Rica 23, which indicates that there is circulation of the bacteria in the region. A teenager can carry the bacterium in his nasopharynx by 25%, that is to say that one in four adolescents carries the bacteria during the time they attend college or leave school, the age at which defenses go down and the percentage of the bacteria, ”explains the infectologist.
Children under one year of age are the most vulnerable group to pneumococcus and are those who arrive at hospitalization or death, says the specialist.
Other vulnerable groups are adolescents from 16 years to adults of 21 years, and above 65 years.
In those ages, a vaccine booster is necessary to avoid any disease caused by pneumococcus, says Dr. Iván Solano Leiva, vice president of the Central American and Caribbean Association of Infectology.
The transmission factors are social, individual and environmental, which depend on the immune system of each person; also, due to the genetic differences of the disease, which now presents mutations that are more aggressive than before; and respiratory diseases that allow bacteria to enter, environmental and seasonal factors, such as cold seasons; and overcrowding, explains the doctor.
Among the social factors is the sharing of drinks and food, smoking, as it irritates the nasopharyngeal mucosa, which makes it easier for the bacteria to stay in the respiratory area; as well as frequent visits to enclosed spaces, says Dr. Dueñas.
“All these factors are teenagers, they go to bars, they are in university classrooms, it is an age when one more kisses, where the most affected are people with chronic diseases,” says the infectologist.
He explains that 10% of the people who carry the bacteria will develop it and many of the cases will be of patients who have risk factors, such as adults with chronic diseases, older adults and health personnel who face cases that They arrive at establishments and are not vaccinated.
“We don’t know how to predict who will develop the disease. And it is so aggressive that we usually talk about the meningococcal disease clock because a child, in 24 hours, can aggravate his health and even die, a disease that starts with nonspecific symptoms, like any other illness with fever, vomiting, nausea, drowsiness, diarrhea, and at 8 o’clock he can already have severe symptoms such as hemorrhagic rash, at 12 o’clock he has already developed a meningitis and at 24 hours this child dies, ”explains Dueñas.
He explains that invasive meningococcal disease is difficult to diagnose and highly fatal, and that despite the existence of good antibiotics, meningococcal meningitis is one of the diseases that has not been able to impact the mortality it causes.
When the child arrives at the consultation with fever and hemorrhagic rash, at 12 or 15 hours after starting the disease, the doctor is already late to be able to make a diagnosis and to give him treatment; At 24 hours the child has developed the disease and dies. Amputations of the limbs occur in survivors of the disease.
Given the disease, the specialist mentions that there is a need for early clinical diagnosis, which is accessible and cheap, since it has a cost of $ 200. Likewise, the identification of the populations that are most at risk, provide a treatment that reduces mortality and sequelae and how to achieve an impact on public health.
“The only way to avoid meningococcal disease is through vaccination, which has been around for 30 years,” says Dueñas.
In El Salvador, in 2018, Salud announced the change in the purchase of the 13th vaccine against pneumococcus, by the 10th, which according to private doctors does not have the same coverage, since the population of the elderly and with chronic diseases as cancer, diabetes or HIV would be unprotected because it leaves out three serotypes of the pneumococcus and is indicated only for children under five years.
After the Health statement, he announced that he would continue to buy the 13-valent vaccine, but in a smaller amount, which would be indicated only for children and older adults with immune system complications.
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