Meningococcus B: case in France, transmission, which vaccine?

Meningococcus B case in France transmission which vaccine

Cases of meningococcal B worried France this winter 2022/2023. Rather benign, this infection can sometimes cause serious illnesses such as meningitis or septicemia, which are potentially fatal. How does she catch it? When to get the vaccine?

Meningococcus B is a bacteria which can be found in the throat, and sometimes in the nose, many people say “meningococcal carriers“, particularly infants and the young children. Most of the time, this bacterium does not cause symptoms or is responsible for mild symptoms. But sometimes it can cause serious diseases like meningitis Where sepsis, potentially fatal. In June 2022, a new strain of meningococcal B had been detected in the region Auvergne-Rhône-Alpesreported I’Regional Health Agency of the region. Furthermore, in January 2023, 6 cases of invasive group B meningococcal disease related to the same bacterial strain occurred in Alsaceannounces the ARS Grand Est in a communicated. Five live in the Strasbourg conurbation and 1 case in the city of Colmar. How is this bacterium caught? What are symptoms ? Does it exist a vaccine to protect yourself from it? Is it compulsory for the baby?

Definition: what is meningococcus B?

Meningococcus B is a bacterium commonly found in the throat and sometimes in the noses of several people. “A bacterium that is found in 5 to 50% of the population depending on age at the level of the nasopharynx“, specifies Dr Belenotti, an internist contacted by the Journal des Femmes in February 2021. In most cases, meningococcus B is asymptomatic and does not cause any particular illnesses. But sometimes it can trigger a serious condition called invasive meningococcal disease with complications meningitis Where sepsiswhich are potentially fatal or which can leave serious sequelae. Meningitis occurs when meningococcus infects the fluid and membranes that surround the brain and spinal cord. Meningococcal sepsis (whose most severe form is purpura fulminans) is a generalized infection of the blood and various organs, which occurs when the meningococcus spreads throughout the body. Vaccination is the only effective way to prevent meningococcus B and its complications.

Diagram of meningococcal meningitis © ellepigrafica – stock.adobe.com / Journal des Femmes

What is the number of cases of meningococcal infections in France?

Diagram of a meningococcus
Diagram of a meningococcus © creativeteam – stock.adobe.com

In France, serious meningococcal infections affect approximately 600 people per year (two thirds meningitis, one third sepsis). Between November 2022 and January 2023, 6 cases of invasive group B meningococcal disease related to the same bacterial strain occurred in Alsaceannounced the ARS Grand Est in a communicated. Five live in the Strasbourg conurbation and 1 case in the city of Colmar. A strain of meningococcus B, detected in June 2022 in Auvergne-Rhône-Alpes claimed 12 victims, including one death. These people were young adults who may have crossed paths during evenings in bars or nightclubs in the hyper-city center of Strasbourg including L’establishing the Live Club. The case residing in Colmar has indirect links with the Strasbourg conurbation through several people around him.

► Invasive meningococcal disease is a notifiable disease in France. Health professionals must inform the Regional Health Agencies, responsible for implementing the necessary management measures.

The transmission is human-to-human, that is to say from human to human, reports the Ministry of Health. Meningococcal B contamination can occur through close (less than 1 meter) and prolonged contact with a person who is a carrier of the bacteria (whether a healthy carrier or a sick person), through airway or by saliva, for example by cough Where the postillions (droplets of saliva). This bacterium does not survive in the external environment, neither on objects nor on surfaces.

At what age does it catch?

People most affected by meningococcal B are children under one year old, children between 1 and 4 years old and unprotected young adults between 15 and 24 years old.

What are the symptoms of meningococcus B?

Most often, meningococci do not cause any particular diseases. But in some cases, they can lead to an invasive meningococcal B infection which is most often manifested by:

  • A fever
  • Of the severe headaches
  • Of the vomiting
  • purpura : red and purplish spots that can appear and grow very quickly (their characteristic: they do not fade or disappear when pressed)
  • Sometimes disturbances of consciousness
  • A pale or even gray face
  • diarrhea
  • Intolerance to noise or light
  • A stiff neck
  • Strong body aches
  • A great tiredness
  • Significant drowsiness
  • eye paralysis
  • Seizures

When should you consult?

The action to take is to contact his attending physician in the event of the appearance of the signs mentioned above. It is urgent to contact the Emergencies (15) in the event of a very high, poorly tolerated fever or the rapid onset of purpura, a sign that the infection has spread throughout the body.

Who are the people most at risk?

  • Immunocompromised people.
  • People who have been in close contact with someone with invasive meningococcal disease.
  • Research laboratory staff working on meningococcus.
  • Travelers, under certain conditions (see with their doctor).
  • The entourage of these people at risk.

What is the treatment for invasive meningococcal B infection?

According to‘Pastor Institutethe seriousness and the risk of rapid development of invasive meningococcal infections requires the very rapid establishment of a antibiotic treatment. It is done intravenously and usually needs to be taken for 4 to 7 days. In France, first-line treatment is used 3 cephalosporinse generation (cefotaxime, ceftriaxone).

What is the meningococcal B vaccine?

The vaccine mainly used for vaccination in France is Bexsero® from the GSK Vaccines laboratory, the first anti-meningococcal vaccine targeting serogroup B pathogenic strains to have obtained marketing authorization in Europe, in January 2013, indicates the High Authority for Health (HAS). It is indicated for the elderly 2 months or more and it is reimbursed up to 65% by Health Insurance within the framework of the recommendations. It is a vaccine composed of several antigens found on the surface of the bacteria, which will lead to the production of protective antibodies against invasive meningococcal B infections.

In France, vaccination against type B meningococcal infections is not compulsory, but recommended (unlike the meningococcal C vaccine which is mandatory). In June 2021, HAS recommends vaccinating all infants, which constitute the age group most vulnerable to these invasive meningococcal B infections, using BEXSERO® according to the MA scheme (first dose at 3 months of age, second dose at 5 months of age and a booster dose at 12 months of age). Namely that a second vaccine – TRUMENBA® – has marketing authorization, but it is only indicated for children from the age of 10 and for the prevention of invasive meningococcal disease caused by Neisseria meningitidis serogroup B.

Given the meningococcal strain identified in Strasbourg (B) between November 2022 and January 2023, and the protocol in force, the Vaccination is recommended for all people attending festive places in Strasbourg city center, in order to limit the circulation of meningococcus B and to prevent the appearance of serious forms. Appointments for vaccination via the platform Doctolib, at the international vaccination center (site of the new civil hospital in Strasbourg), with 100% coverage. A prescription is not necessary.

Sources: Site of the Institut Pasteur / Auvergne-Rhône-Alpes Regional Health Agency / Ministry of Health / ARS Grand Est.

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