Spanish immunise against meningitis

SPANISH authorities are carrying out a mass vaccination in several provinces against meningococcal meningitis C, the type which…

SPANISH authorities are carrying out a mass vaccination in several provinces against meningococcal meningitis C, the type which most commonly occurs in Ireland. Inspite the fact such action is normally only taken in epidemic situations, the Spanish government is insisting it does not have an epidemic.

So far this year, there have been at least 30 deaths and more than 400 cases of the disease. These figures are still rising. The Ministry of Health says the numbers are within the parameters of what is considered normal and represent only a small increase on the same period last year though it's difficult to understand how this comparison can be made, given that the Ministry did not have a death figure available for January and February 1996.

"Keep calm," is the message from Jose Manuel Romay Becarria, the Health Minister, "everything is under control." But his appeals are falling on deaf ears. Health centres, hospitals and doctors' surgeries have been swamped by worried parents. One man queuing with more than 6,000 people in Madrid to obtain the vaccine compares the situation to a plane crashing. "The pilot isn't going to say we're all going to die. He tells you to keep calm and with this it's the same. The government isn't going to say that there's an epidemic.

The current mass vaccinations against meningitis C are taking place in Galicia, Cantabria and La Rioja, all in the north of Spain and where the incidence of meningitis C has nearly reached 12 per 100,000 of the population the level designated by the World Health Organisation as epidemic. In these three provinces all children between the ages of two and 18 years are being vaccinated.

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Elsewhere, the vaccine is being restricted to those who have come into direct contact with the disease. Antibiotics are also being used as a preventative measure. The vaccine is not effective in babies under two tragically, these are the ones most at risk.

The vaccine currently being used in Spain has been around for nearly 20 years but is not used by any country in its routine vaccination programme because it is only effective for three to five years. This is why it is usually reserved for controlling epidemic outbreaks. It does not induce the memory of the immune system like most other vaccines but, according to the manufacturers Smith Kline Beecham, re-vaccination can, if necessary, be safely carried out, producing the same level of anti-bodies each time.

It is precisely this type of information which has apparently not been made known to the general public in Spain and while the government can deny the existence of an epidemic of meningitis C it cannot deny an epidemic of hysteria all over the country.

Several parents have even travelled to France to buy the vaccine, believing that the government's decision not to vaccinate the whole population indicated a shortage off vaccines. The Meningitis Research Association (MRA) in Britain has had many calls from Spain as parents desperately seek information which is not being given to them in their own country.

The alarm, ignorance and uncertainty are such that some doctors admit they're administering the vaccine more to combat parents' anxiety than because its indicated for the child.

"This is not the way to use the vaccine," insists Manuel Moya, the president of the Spanish Paediatric Association. "It should only be given where there has been very close contact with an affected person."

The government has now ordered three million doses of meningitis C vaccine. Ironically this has just convinced people the government is preparing for the worst.

There have been no suggestions that tourists should avoid Spain at this time. Andalucia, which includes the popular holiday destination of the Costa del Sol, has the lowest incidence in the whole of the country. The MRA advises that the risk of contracting meningitis is very small because most people have a natural resistance to the bacteria. It is carried in the nose and throat by at least one in 10 of the population at any one time.

The winter months of December, January and February are usually when most cases of meningitis occur, so the authorities in Spain hope that shortly the crisis will be over.