June 3, 2005

SIKESTON - It can appear in an instant, and result in disabilities or death. Meningococcal meningitis may only affect about 2,600 people nationwide during a year, according to the Centers for Disease Control and Prevention, but it kills a fifth of the people who get it...

SIKESTON - It can appear in an instant, and result in disabilities or death.

Meningococcal meningitis may only affect about 2,600 people nationwide during a year, according to the Centers for Disease Control and Prevention, but it kills a fifth of the people who get it.

"It's not very common, but it is very aggressive when you get it," said Dr. Kevin Blanton, pediatrician at Ferguson Medical Group in Sikeston.

Last week, the CDC and the American Academy of Pediatrics announced their recommendation that 11 to 12-year-olds, students entering high school and college freshman preparing for dorm life receive the newly licensed meningococcal conjugate vaccine.

This recommendation followed the FDA approval of the new vaccine in January and the urging of a government advisory panel in February for federal health officials to recommend the shot be given to people in those age groups, who are believed to have the highest risk of contracting the disease.

The supply of the vaccine at this time limits the recommendation to these high risk groups, but it will ultimately be recommended people ages 11 and older, Blanton said. Since health care providers try to schedule shots to be administered at the same time, he expects the recommendation to be combined with the tetanus booster shot juveniles receive at age 12.

The new vaccine will be marketed as Menactra, and is expected to protect against meningitis for up to 10 years. It will replace Menomune, which has been used to prevent the disease since 1981; and is currently licensed for people between 11 and 55 years of age.

The new vaccine has some improvements over Menomune. "The effects of Menomune did not last as long as Menactra will last," said Jeanne Stalker, RN at the Scott County Health Department.

One downfall in both of the vaccines is the lack of protection for meningitis caused by serogroup B bacteria, one of the five common serotypes.

"Depending upon what cities you look at, type B causes about 25 percent of the illness," Blanton said. "So it is very effective against the other subtypes, but not at all for subtype B."

In addition to those in the high risk group, the shot is also recommended for those with certain chronic illnesses, according to Blanton. Those who have problems with their immune system, without a spleen and who have sickle cell disease are also advised to get the shot.

Vaccine recommendations will also stretch to younger children in the near future. "Ultimately, it (meningitis) is a little bit more common for younger kids in the toddler age and below," Blanton said. The occurrence for meningitis in babies and small children is 1 in 10,000 compared to 1 in 100,000 for older people, he pointed out.

But right now there have not been enough studies to approve the vaccine for children younger than 11. "It's not approved yet, but anticipated in the next couple of years," Blanton said.

And only one shot is needed in one's lifetime as of right now. "As far as we know, a one-time dose will get you indefinitely," Blanton said.

Most people who received Menomune should not need the new shot. However, if it has been four to five years since someone in the high-risk group received the old version of the shot, they might want to get the new shot, according to Blanton.

The Health Department has not yet received Menactra, but is expecting it soon, according to Stalker. "It should be here in the very near future," she said.

On the other hand, the new vaccine is available at Ferguson Medical Group. "We have it in the office," Blanton said.

But they aren't administering it to too many patients yet. The shot will cost over $120, which is a bit cheaper than the old vaccine, according to Blanton. And not all insurance companies are covering the cost of the vaccine at this time, since it is so new.

Earlier this week, HealthLink and Blue Cross Blue Shield, the major insurance providers at Ferguson, officially agreed to cover the cost of the shot. Vaccines for Children, a program for people without insurance or on Medicaid has not made an agreement yet.

"They eventually will, it just takes awhile to do it," Blanton said. "It will probably be approved over the next several months."

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