Meningitis B latest: ‘Worst case scenario’ could be another super-spreader event, warn health officials

The Independent’s health reporter Rebecca Whittaker reports:

Scientists say the meningitis strain is not a new variant and may not have mutated into an “invasive strain”.

Professor Brendan Wren, Professor of Microbial Pathogenesis, London School of Hygiene & Tropical Medicine said: “The initial sequence data confirms that it is a single menB strain causing the current cluster of meningitis cases.

“The MenB ST-41/44 clonal complex has been previously identified in the UK and is not a new variant. This suggests that the strain has not mutated into a more invasive strain, but scrutiny of the full genome sequences and further studies will be required to confirm this.

“The current Bexsero MenB vaccine based on the cell surface antigens of MenB strains should provide protection against the MenB ST-41/44 variant.”

The Independent’s health editor Rebecca Thomas reports:

European health authorities have said the current UK outbreak of meningitis is of “very low risk” to the general population in Europe.

In a response published this week, the “The European Centre for Disease Prevention and Control (ECDC) assesses the risk to the general population in the European Union and European Economic Area (EU/EEA) of invasive meningococcal disease (IMD) related to the outbreak in Kent, England, as very low due to the very small probability of exposure and infection. If a case linked to the outbreak in England is detected in the EU/EEA, control measures should be promptly initiated to identify close contacts and administer antibiotic prophylaxis and meningococcal B (MenB) vaccination.”

However, it advised that clinicians should be aware of the possibility of meningitis in returning travellers and include travel history when assessing invasive meningococcal disease, particularly regarding those who’ve travelled to Kent.

The number of cases of meningitis linked to the outbreak in Kent has risen to 29, the UK Health Security Agency (UKHSA) said on Thursday, up from 27. Some 2,360 vaccinations and 9,840 doses of antibiotics have been given to those affected by the outbreak.

The Independent’s health reporter Rebecca Whittaker reports:

A health official has said a ‘staggering’ 2,642 people have been vaccinated against meningitis so far.

Dr Anjan Ghosh, the director of public health at Kent County Council, said: “We fully expect that anyone who, because the criteria have been extended, so anyone who’s entitled to prophylaxis (antibiotics) is entitled to the vaccination. So that’s quite a large number of people.”

Earlier, the deputy chief executive of NHS Kent and Medway said his top priority was to “maximise capacity” and ensure everyone who wants a meningitis vaccine is able to get one.

The public health director of Kent County Council said the worst case scenario of another “super spreader” event is “very unlikely to happen”.

Dr Anjan Ghosh said it is most likely that the cases will be contained in Kent with a few additional cases outside of the county, which are easy to contain.

He added: “The worst case scenario is that there’s another type of event like what happened in Kent so some sort of super spreader event or something more and therefore you have a bigger, much bigger cluster like you had in Kent happening elsewhere. That’s very unlikely to happen.”

If infected students have gone home for the Easter break, it “would be a very limited to household kind of thing which can be easily managed.”

The Independent’s health editor Rebecca Thomas reports:

In an update on Friday, the UK Health Security Agency has confirmed the strain of meningitis driving the outbreak, Meningitis B, is covered by the current Bexsero vaccine.

It has published details of the variant of MenB that has been identified for scientists and experts to further study.

Speaking to The Independent, Dr Shamez Ladhani, a paediatric infectious diseases specialist at St George’s Hospital, said: “So there are two theories. One is that it could be more transmissible and jump from person to person very quickly, or it could be more severe.”

However, he said the transmissibility will only be known retrospectively, reflecting on the number of cases.

“There was a big exposure event that happened, and a lot of young adults got sick. It seems to be linked very closely to the nightclub. It seems like they all got exposed, very close to each other, which is why you’ve had so many cases so close to each other, and now cases have slowed down.

He said: “As it stands, at the moment the risk outside those involved in the Kent outbreak is that baseline…It’s unprecedented in terms of the numbers that got sick so quickly but apart from that, it is behaving normally. This is what [meningitis] does.”

In relation to the variant, he said: “It is a variant of one of the common strains, [MenB], but that doesn’t have any meaning so far; we don’t know what that actually means; it could be nothing. Meningococcal is one of the diseases most genetically able to mutate very quickly.

“That’s why it moves very quickly. So it actually has an incredible ability to acquire new genes and transfer new genes. So it’s constantly changing itself. Luckily its still preventable by the B vaccine.”

In terms of severity, the outbreak was currently behaving “atypically” as would be expected.

He added, “It’s a nasty disease, and it’s acting like a nasty disease. This is what it does; there’s no evidence that it’s more aggressive; it’s just a horrible disease.”

The father of Juliette Kenny, who died aged 18 in the meningitis outbreak, has paid tribute to his daughter.

Michael Kenny called on health officials to extend the NHS vaccine programme, saying the loss he is experiencing “can be avoided”.

Here is his statement in full:

“We are incredibly proud parents to two wonderful daughters. Juliette is a force in this world. With her beautifully positive energy she spread fun, love and happiness to those around her and she continues to do so now. The devastation of her loss to us, her family and friends is immeasurable.

“Sharing stories of the empathy, warmth and fun that she created is helping her family and friends through at this time. Her energy continues to make the people who love her find a way.

“The illness took her from us so quickly. On Thursday 12th March, she successfully completed a practical element of her P.E. A-level. She was fit, healthy and strong. In the early hours of Friday 13th Juliette vomited. There were no other symptoms at this time. In the morning on Friday, she was taken, by us, to our local emergency drop-in as a discolouration appeared on her cheeks.

“She was given antibiotics and sent by ambulance to A&E. Juliette fought bravely for hours, but despite the fantastic NHS hospital staff fighting alongside her, meningitis took her from us less than 12 hours later. We were with her at the end, and the last sounds that she heard were the voices of those who loved her telling her how very much loved and cherished she is.

“No family should experience this pain and tragedy. This can be avoided. There are young people currently battling this and young people still at risk.

“As parents, we knew our children would change the world and be a force for good. The work to protect young people has started. It needs to be more. Juliette’s impact on this world must be lasting change. Now is the time to ensure families are safe from the impact of meningitis B.”

The Kent County Council public health director Dr Anjan Ghosh said it is “too early to say” if the number of cases has peaked.

Dr Ghosh said that the data makes it appear cases are going up exponentially, but “it’s not”.

“Hopefully it’s starting to slow down. I think until next week, we won’t be able to say for sure, the normal sequelae of an outbreak of this sort is about four weeks,” he added.

“That’s the timeframe for it to really slow down. So fully expect, in four weeks’ time that it slowed down, but we can’t say whether it’s peaked yet.

“These are all cases which are relating to that same period of time, it’s just that the reporting cycle it takes time for them to be reported, it takes time for the incubation period which is quite wide for people to actually start showing symptoms. It’s not like it’s spreading and more and more people are getting the infection.

“We are looking into secondary infections to make sure that that is not the case and we haven’t yet been able to definitively say that’s not the case, but for majority it all relates to that same single point in time.”

Health officials have suggested that the “peak” of the outbreak has passed.

The deputy chief executive of NHS Kent and Medway said his top priority was to “maximise capacity” and ensure everyone who wants a meningitis vaccine is able to get one.

Ed Waller told reporters: “What we’re trying to do is to use our capacity to deliver consistently through the days.

“We had all of our nurses and others delivering vaccinations.

“They delivered it late into the evening on Wednesday, they started very early Tuesday, worked all the way through, they are here again this morning, they’ll be through the weekend.

“So we’re doing everything we can to keep the sites open at maximum capacity.”