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Symposium on Meningococcal Meningitis - Meningitis is a major cause of child mortality in Pakistan.

KARACHI -- Meningitis is a major cause of child mortality in Pakistan where 5% of all under five years of age child deaths are due to Meningitis. Polysaccharide vaccines cannot be used in children under two years of age. However Polysaccharide-protein conjugate vaccines can be used in young children. Introduction of serogroup C conjugate vaccine helped in 93% reduction in serogroup C diseases in UK which was a dramatic reduction in 2004. These views were expressed by Dr. Zulifqar Bhutta, Professor Department of Paediatrics & Child Health, Division of Women and Child Health AKU, Karachi while speaking at a seminar on "Meningococcal Meningitis deadly but preventable". It was jointly organized by Trust for Vaccines and Immunization and Novartis Pharma Pakistan and was largely attended by pediatricians, physicians and Pathologists.

Dr. Zulifqar Bhutta, (second from Left) replying to question during a seminar on "Meningococcal Meningitis deadly but preventable" jointly organized by Trust for Vaccines and Immunization and Novartis Pharma Pakistan at a local hotel in Karachi recently. Sitting others on the dais from (L to R) are Dr. Aysha Mehnaz, Prof. Jamal Raza and Dr. Asad Ali.

Meningococcal disease Dr. Bhutta further stated is potentially fatal and should always be viewed as a medical emergency. Appropriate antibiotic treatment must be started as soon as possible, ideally after the lumbar puncture has been carried out if such a puncture can be performed immediately.

Talking about prevention Dr. Bhutta said that the best protection against Meningococcal disease is vaccination. There are two types of vaccines available. Polysaccharide vaccines have been available to prevent the disease from many years. Meningococcal polysaccharide vaccines are available in either bivalent (groups A and C), trivalent (groups A, C and W), or tetravalent (groups A, C, Y and W135) forms to control the disease. For group B, polysaccharide vaccines cannot be developed, due to antigenic mimicry with polysaccharide in human neurologic tissues. Consequently, vaccines against B is being developed in Norway, in Cuba and Netherlands are outer membrane proteins (OMP). Since 1999, meningococcal conjugate vaccines against group C have been available and widely used. Tetravalent A, C, Y and W135 conjugate vaccine have been licensed since 2005 for use in children and adults in the United States and Canada.

Members of Marketing and Sales team of Novartis Vaccine Division photographed at a seminar on "Meningococcal Meningitis deadly but preventable" organized by Trust for Vaccines and Immunization and Novartis Pharma Pakistan in Karachi recently.

From December 2010, a new meningococcal A conjugate vaccine is being introduced globally and has several advantages over existing polysaccharide vaccines. It induces a higher and more sustainable immune response against group A meningococcus, it is expected to confer long-term protection not only for those who receive the vaccine, but to family members and others who would otherwise have been exposed to meningitis and it is expected to be particularly effective in protecting children under two years of age, who do not respond to conventional polysaccharide vaccines. According to WHO recommendation conjugate Meningococcal vaccines reduces nasopharyngeal carriage and protect children age < 2months to <5years against meningococcal diseases.

Talking about implications for Pakistan Dr. Bhutta said that good national data is very essential for making strategy and control of diseases. It is important to invest in prevention and we are lacking behind in this regard. Introduction of Hib vaccine into the EPI even much earlier than India helped us a lot Dr. Bhutta added.

Dr. Asad Ali, Assistant Professor of Paediatric and Child Health at AKU talking about Global burden, epidemiology and prevention strategies for Meningococcal diseases said that twelve groups of N. meningitidis have been identified, five of which (A, B, C, W135, and X) can cause epidemics. Serogroup A is the leading cause of epidemic meningitis worldwide. B is a major cause of endemic diseases in Europe and America and no vaccine commercially available. C is major cause of endemic in Europe and North America while Y is infrequent worldwide. There are about four hundred thirty million people at risk of meningitis in African Belt. There are two peaks of the disease one in infancy and other in adult age. Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the thin lining that surrounds the brain and spinal cord. The bacteria are transmitted from person to person through droplets of respiratory or throat secretions.

Close and prolonged contact such as kissing, sneezing or coughing on someone, or living in close quarters such as a dormitory, sharing eating or drinking utensils with an infected person facilitates the spread of the disease.

Talking about prevention Dr Asad said that outside of the meningitis belt clearance antibiotics are effective and treatment should be started within 24 hours of identification. Polysaccharide vaccines and conjugate vaccines are available for meningitis prevention. Burden of Meningitis in Pakistan needs to be clearly established, he added. Prof. Jamal Raza, Director NICH, and Dr. Aysha Mehnaz, Professor of Paediatric DUHS, Karachi were the other panelist with Dr. Zulfiqar Bhutta and Dr. Asad Ali, who replied to the questions from the audience. Dr. M. Shahzad Saleem Business Unit Head of Novartis Vaccine Division presented the vote of thanks.
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Publication:Pulse International
Article Type:Conference notes
Geographic Code:9PAKI
Date:Oct 14, 2011
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