This week’s post was somewhat difficult to write because in the search for articles covering meningitis, I mostly ran into articles comparing meningitis and COVID-19 somehow. I had the same problem for tuberculosis and HIV. Although it was annoying, it shows how easily other public health concerns are being pushed to the side amidst efforts to make vaccines and treatments for COVID-19. For those at risk for meningitis, particularly those in the “meningitis belt,” this will be detrimental, as mass vaccine efforts are being put on pause. Knowing that so many people will suffer because of this is concerning, especially as I have some personal “beef,” if you will, with meningitis. One of my cousins living in El Salvador contracted, and passed away, from a bacterial meningitis infection at the young age of 9. He and his family lived in an impoverished part of El Salvador, with the nearest hospital about 2 hours away. His situation is likely very similar to those in the “meningitis belt” of Africa who have little access to medical care and rely on preventative measures like mass vaccination efforts to avoid these life-threatening infections.
Some more “bad news” about meningitis is that it is quickly developing antibiotic resistance, so preventative measures are growing even more important to lowering the death rate for bacterial meningitis infections. There is also good news, though, there are studies being conducted that are showing potential improvements for the Neisseria meningitidis vaccine. The form of meningitis that is caused by this bacteria has a 20% fatality rate, and about 15% of those who survive the infection suffer lifelong impairments (da Silva, et.al, n.p.). The problem with this organism and vaccine effectiveness is that the bacterial protein mutate and change continuously, decreasing the efficacy of vaccines. A group of researchers at the University of Nottingham studied over 2000 isolates and found that 88% of strains made a precursor Factor H binding protein (FHbp), a lipoprotein found in the cell wall of the bacteria (da Silva, et.al, n.p.) Although the FHbp itself undergoes mutations and is constantly changing, this precursor molecule is the same in a majority of strains, so a vaccine targeting this precursor protein is effective regardless of which final version of FHbp the bacterial strain makes. This is the basis of two new meningitis B vaccines, which are major causative agents of meningitis in some countries and lack effective, widely used vaccines.
Another way to decrease meningitis occurrence, specifically in the African “meningitis belt” is to reinforce the medical and laboratory structures dedicated to detecting and monitoring bacterial meningitis cases and outbreaks. This is precisely what is being done. Foundations such as MedAfriNet are placing an emphasis on basic microbiological tests and specimen transport to laboratories to confirm cases as a way to manage meningitis cases in Africa significantly better (Feagins, et.al., n.p.) Another reason that laboratories are being reinforced is because of the changing epidemiology of bacterial meningitis. There are several “groups” and each outbreak is different, so being able to identify the margins and populations being affected by, let’s say, group B meningitis and group W meningitis, is important for combatting and stopping outbreaks (Feagins, et.al., n.p.) Efforts like these are extremely important because they consider the disease and it’s spread from a “big picture” perspective. Similar strategies are used for other diseases such as HIV and TB, and even COVID-19.
Jaylin’s Thoughts: Microbiology 