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What we know about meningococcal disease amid the outbreak in Toronto

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As Canada’s health care system struggles amid health worker shortages and burnout as Canadians continue to grapple with the threat of COVID-19 and monkeypox, news of another disease threatening potential has raised questions and concerns among Canadians.

On Thursday, the city of Toronto declared an outbreak of meningococcal disease after one person died and two others remained infected.

But what is this life-threatening disease and what tools do we have to deal with it? This is what we know about the infection.

WHAT IS IT?

Meningococcal disease refers broadly to illnesses caused by a specific bacterium called Neisseria meningitidis, sometimes called simply meningococcal bacteria.

These diseases can include meningitis, an inflammation of the fluid that surrounds the brain and spinal cord. It can also cause septicemia, a severe form of sepsis in which the blood becomes infected.

Not all types of meningitis are caused by meningococcal disease, as it can be caused by several different types of bacterial infections, viral infections, or even a fungal infection, in rare cases.

The presentation of invasive meningococcal disease can vary depending on whether it progresses to meningitis or septicemia, but all forms of meningococcal disease are an emergency and require immediate medical attention.

About one in 10 people who get meningococcal disease will die, and up to a fifth of survivors may have long-term disabilities, such as brain damage, deafness, or loss of limbs, according to the Centers for Disease Control (CDC). from USA

Meningococcal disease is endemic in Canada, meaning that outbreaks do occur from time to time, although they are rare, and the incidence rate varies across the country.

Between 2012 and 2019, the national average incidence rate was 1 case per 290,000 people. According to Health Canada, the most recent documented outbreak was in 2017 among five teenagers in BC

HOW IS IT SPREAD AND HOW INFECTIOUS IS IT?

Meningococcal disease is spread through close contact with other people’s saliva through activities such as kissing, coughing, or sneezing, as well as sharing items that are inserted into the mouth, such as toothbrushes, cigarettes, mouth guards, lipstick or lipstick or musical instruments played with the mouth.

About one in ten people are carriers of the meningococcal bacteria, meaning they unknowingly carry it in their noses and throats without getting sick themselves.

Meningococcal bacteria are much less transmissible than the virus that causes COVID-19: you cannot get meningococcal disease simply by breathing the same air as someone who carries the bacteria.

It’s also more difficult to spread than the common cold or the flu, according to the CDC, and a person usually needs close and prolonged contact with a patient to catch it.

When a person gets the disease, their family members, roommates, and romantic partners are at increased risk of getting it, too.

HOW DO YOU KNOW IF YOU HAVE IT?

A person who has contracted the disease will begin to experience symptoms two to 10 days after exposure, with most symptoms appearing within three to four days, according to Health Canada.

Common symptoms include sudden fever, headache, and stiff neck for people with meningococcal meningitis, potentially accompanied by vomiting, sensitivity to light, and confusion.

For those with septicemia caused by meningococcal disease, symptoms may include fever and chills, vomiting, fatigue, cold hands and feet, muscle aches, and diarrhea.

In later stages, meningococcal septicemia may be accompanied by a rapidly spreading skin rash that begins as purple spots.

Because many of the early symptoms are so similar to those of other diseases, the disease must be diagnosed through laboratory tests, so it is important to seek medical attention as soon as you suspect you may have the disease.

Without treatment, a patient could end up hallucinating, falling into a coma, or even dying.

HOW IS IT TREATED?

People with invasive meningococcal disease are treated with antibiotics for three to seven days. Doctors will give antibiotics as soon as a person suspects they have the disease, even before confirmation, to reduce the risk of the disease progressing to death.

If the disease was only contracted in the later stages, a person might be hospitalized for respiratory support, care for skin damaged by a rash, or surgery for dead tissue.

IS THERE A VACCINE?

There are several vaccines approved for use in Canada that target well-known serogroups of meningococcal disease. The Men-C vaccine protects against type C, the quadrivalent meningococcal vaccine protects against types A, C, Y, and W-135, and the Men-B vaccine protects against type B.

According to the City of Toronto, the three people confirmed to have contracted meningococcal disease on Thursday had the “same rare strain of serogroup C meningococcal disease.”

Babies in Canada can receive the Men-C vaccine as part of routine two-dose immunizations at 2 and 12 months.

The Men-C or quadrivalent vaccine is offered through school immunization programs in all Canadian provinces and territories, although the grade at which the vaccine is offered varies from grade 6 to 12 depending on the region.

In Ontario and New Brunswick, proof of vaccination against meningococcal disease is required for all children attending school.

While many people in Canada will have received the meningococcal disease vaccine through these routine immunizations given to children, large immunization programs to vaccinate against meningococcal disease only became widespread in Canada in the early 2000s, although there were several immunization campaigns that were launched in the 1990s in response to outbreaks in certain provinces.

This means that many adults may never have received a vaccine.

The city of Toronto on Thursday urged residents to find out if they received the meningococcal vaccine.

“Adults between the ages of 20 and 36 who have not received a meningococcal disease vaccine are strongly encouraged to contact their health care provider to receive a meningococcal disease vaccine as soon as possible,” the statement read. “TPH will monitor the demand for vaccines and is actively exploring additional vaccination channels.”


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