Working Together to Defeat Invasive Meningococcal Disease
Lucie Marisa Bucci, Senior Manager, Immunize Canada
Megan Acton, Program Manager, International Federation on Ageing (IFA)
April 24 is World Meningitis Day, and on this day, the International Federation on Ageing (IFA) together with the Confederation of Meningitis Organisations (CoMO) and Immunize Canada want to remind you that meningococcal disease is a health risk you should not take. As we grow older, our immune system does not function as well as it once did. We become more susceptible to infectious diseases at a time when illness can lead to complications, hospitalization, and changes in health, and affect our ability to be independent.
Vaccines and proper hygiene like washing your hands with soap and water are vital tools for reducing our risk of illness throughout our life course, because outbreaks of infectious diseases can occur in our community at any time. Several vaccine-preventable diseases continue to be endemic in Canada. Invasive meningococcal disease (or IMD) is one of those diseases. It is a serious disease caused by five groups of meningococcal bacteria, namely - A, B, C, Y, and W-135, and while it occurs at low rates, it poses a serious threat to our health and well-being.
According to the World Health Organization (WHO), epidemics of IMD occur frequently, particularly in areas of the world where IMD is endemic.1 In Canada, meningococcal B and meningococcal C are the primary causes of infection.2 However, surveillance data indicates that meningococcal Y is more frequent in adults 65 years and older.3 In fact, meningococcal Y accounts for 50% of IMD infection in this age group, and is the cause of severe complications such as septic shock, pneumonia and meningitis. For the most part, IMD health outcomes in older adults are devastating.4 Ten to 20% of IMD survivors face secondary effects that are life changing such as long-term disability, neurological complications, hearing loss, limb amputations, and motor/cognitive impairment.5 Death occurs in approximately 10% of IMD cases.6
However, over the last 20 years, immunization programs against IMD have been very successful. These programs have primarily targeted children, adolescents, and young adults. The protection of older adults has been found to be an indirect benefit of these programs, supported by evidence of disease reduction due to lower transmission rates.7 However, there is uncertainty regarding the lasting impact of this immunity on older adults. Therefore, vigilance remains important in adult populations that remain under immunized and for adults who are at higher risk.
For example, Canadian national immunization recommendations focus on the protection of adults at higher risk of IMD infection.8 These include adults with a spleen that is either not working or has been removed; deficiency of complement, properdin or factor D; sickle cell disease; and HIV, particularly if congenitally acquired. Other groups of adults at high risk include those who live in residential accommodation or plan to travel abroad to areas with high rates of endemic IMD or transmission, such as the meningitis belt of sub-Saharan Africa and pilgrimages to the Hajj in Mecca, Saudi Arabia.
While immunization is the most effective way to reduce the risk of IMD illness, access to vaccines for adults may vary between Canadian provinces and territories. Vaccines not part of routine vaccinations for adults may be accessed via a health care provider at a cost. Everyone wants to make the right choices to maintain their health, and it is more important than ever for you to be immunized against IMD. Talk with your health care provider about which vaccines are available in your area.
"Meningitis affects millions of people every year but it doesn’t have to. This World Meningitis Day we can all play a role in helping to defeat meningitis by 2030. Even small actions can make a difference - whether that's learning the signs and symptoms, finding out the preventative options available to you and being fully immunised, or starting a conversation about the disease and its after effects, “says Chris Head, The President of the Confederation of Meningitis Organisations (CoMO). IMD is a devastating illness, but together we can defeat it.
Everyone can get involved to #DefeatMeningitis. For more information, visit:
- Confederation of Meningitis Organisations
- Immunize Canada
- Meningitis Research Foundation
- Meningitis Research Foundation of Canada
- World Health Organization (WHO), Meningococcal Meningitis. Available online.
- Gilca R, Deceuninck G, Lefebvre B, Tsang R, Amini R, et al. (2012) The Changing Epidemiology of Meningococcal Disease in Quebec, Canada, 1991–2011: Potential Implications of Emergence of New Strains. PLoS ONE 7(11): e50659.
- Baccarini C, Ternouth A, et al. The changing epidemiology of meningococcal disease in North America 1945-2010. Hum Vaccin Immunother. 2013;9(1):162-171.
- Sadarangani M, Scheifele DW, Halperin SA, Vaudry W, Le Saux N, Tsang R. Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: A retrospective cohort study. Clinical Infectious Diseases. 2015;60(8):e27-235.
- Pace D, Pollard AJ. Meningococcal disease: clinical presentation and sequelae. Vaccine. 2012;30(suppl2):B3-9.
- Nadel S. Ninis N. Invasive meningococcal disease in the vaccine era. Front Pediatr. 2018;6:321.
- Barrow R, Alarçon P, Carlos J, Caugant DA, Christensen H, Debbag R, et al. The Global Meningococcal Initiative: global epidemiology, the impact of vaccines on meningococcal disease and the importance of herd protection. Expert Review of Vaccines. 2017;16(4):313-328.
- National Advisory Committee on Immunization (NACI). An Advisory Committee Statement (ACS): Update on Quadrivalent Meningococcal Vaccines Available in Canada. April 2015. Available online.