Honoring World Meningitis Day
By Dr. Corey Robertson, Senior Director of Scientific and Medical Affairs
When there is only so much you can do to help in a crisis, you become very committed to doing those things you believe will make a real impact. That was an unforgettable lesson from my time working in the Communicable Disease Service at the New Jersey Department of Health. Part of my job was investigating infectious disease outbreaks, including those caused by vaccine-preventable diseases like meningococcal disease.
On this World Meningitis Day, I reflect on one episode in particular – a high school outbreak of meningococcal disease that involved three students. This occurred before the availability of the quadrivalent meningococcal conjugate vaccines that we seem to take for granted today. In that community, like in many others, there were those who had not heard of meningococcal disease or had just a passing familiarity with it, and so thought the disease was more contagious than it actually was. In the face of mounting panic, my public health colleagues and I had to provide information and context. It was a difficult sort of dance. In one breath, we were trying to reassure parents and officials that the disease was not as contagious as is the flu or common cold, and that a child would not be automatically infected just by virtue of having been in school, while in the next, we had to educate them that close contacts needed to be identified so that they could receive antibiotic prophylaxis.
Because of the current COVID-19 pandemic, more people now recognize the importance of contact tracing and disease investigation. This has not always been the case; my past experiences revealed that tracking infection risk was complicated by the simple fact that the people we were contacting did not understand why we were asking our questions, and why their answers were important. Those with privacy concerns were understandably hesitant. We had to quickly educate large communities to prepare them for the fact that they might be contacted by representatives from the health department. We encouraged them to be forthcoming about with whom they had been in contact, and for how long. Most importantly we had to help them understand that these interviews were an important step in containing what could become a very serious outbreak. The rigor of our investigation was necessary, even as it fueled the fears we were trying to quell.
Lessons learned from the experiences I describe above certainly carry over to the work that Sanofi performs today: being diligent has been and remains an essential habit for the company. As meticulous as Sanofi has been in our work to develop meningococcal vaccines, we must be just as thorough in addressing the shortcomings that surround the awareness of meningococcal disease – among healthcare providers as well as in communities. While rare, cases of meningococcal disease do still occur – and lead to consequences so severe that they serve to underscore the notion that one case is one too many. Meningococcal infection can evolve rapidly, claiming a life in as little as one day. Even with appropriate treatment, 10 to 15 percent of those who get the infection may die from it. Among survivors, as many as one in five live with permanent disabilities that may include cognitive impairment, hearing loss, scarring and limb loss.
To help prevent these tragedies, I would like to see our healthcare system adopt a more thorough use of data and analytics to determine where vaccination uptake is lacking and what factors might influence vaccination coverage—for better or for worse. At a local level, regularly tracking immunization rates can prevent the false sense of security that the tragedy of meningococcal disease “could never happen here.” More broadly, eliminating the current disconnects that exist between jurisdictional and state-level registries and databases, disconnects which deprive us of valuable information, is critical. Promoting and supporting more widespread adoption of electronic health records and using technology to forge better connections and enhance coordination among different data sets will help us to understand where there are gaps in protection. It is only after identifying such gaps (and understanding why they exist) that we will be in a position to successfully tackle them.
We need to be as diligent in prevention as we are once a tragic outbreak occurs. If we heed this call to action we will have yet another way to help prevent meningococcal disease in individuals and communities.