:: Vancouver Sun – Teen’s meningitis death a ‘1-in-10-million chance’ ::

Teen’s meningitis death a ‘1-in-10-million chance’

Strain of bacterium that killed Coquitlam boy is rare in Canada, and almost unheard of in his age group, B.C. health officer says

Nicholas Read, Vancouver Sun
Friday, April 27, 2007

The chances of someone like Coquitlam teenager Brodie Campbell dying of the meningitis bacterium that killed him are one in 10 million, according to provincial health officer Dr. Perry Kendall.

That’s because meningococcal Y, the strain of bacterium that infected the 15-year-old, is rare in Canada, and almost unheard of in children his age.

“In a population of four million, we get three to four cases of Y every year,” said Kendall. “And almost all of them are in people over 25.”

That’s why, even though there is a brand new vaccine against meningococcal Y — it was made commercially available only within the last year — it is not yet given out routinely to B.C. infants, the way vaccines against other sources of meningitis are.

Only Prince Edward Island has made it available through its provincial medical services plan.

Currently in B.C., doctors may prescribe it, but it costs $80 plus a dispensing fee,
unless an individual is deemed to be particularly susceptible to meningitis, in which case it is available through MSP.

Individuals are considered susceptible if their spleen has been removed, or if they’ve had an organ or cell transplant, a cochlear implant or a sickle cell disease.

What makes things so complicated, says Dr. Reka Gustafson, a communicable disease specialist with the Vancouver Coastal Health Authority, is that there is no single cause of meningitis, which, in its broadest sense, means that the lining around the brain and spinal cord — parts of the body that should be free of bacteria and viruses — has been infected by a foreign agent.

But that agent could be any one of a number of different types of bacteria and/or viruses, Gustafson said. Even E. coli, a bacterium present in all mammals’ intestines, can cause meningitis in rare instances.

So there’s no such thing as a vaccine against meningitis per se.

What there are, said Gustafson, are vaccines against seven types of pneumococcal meningitis, against meningococcal C — one of five meningococcal bacteria that can cause meningitis — and against haemophilus influenzae, which, until the development of a vaccine was the most common cause of meningitis in B.C.

The vaccine against the form of meningitis that killed Brodie is called Menactoa.

In addition to targeting the Y strain, it targets meningococcal A, C and W135.

There is a fifth meningococcal strain as well — meningococcal B — but so far there is no vaccine against it.

On average, says Kendall, there are about 32 cases of meningitis in B.C. per year, and of those, 70 per cent are caused by strains B or C.

Between 2002 and 2006, there were a total of 145 cases resulting in 20 deaths. Of those 20 deaths, 13 were from meningococcal C, four from strain B, two from strain Y, and one which couldn’t be typed.

Right now, the B.C. Centre for Disease Control is considering the implications of recommending that the province publicly fund the distribution of Menactoa to all B.C. children.

That decision — mainly a financial one — will be made by the health and finance ministries, but it is up to the BCCDC to make recommendations. continued

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