Researchers find high incidence rates and deaths in first-ever analysis of the disease impacts in Latin America
Buenos Aires, March 20, 2012 (PAHO/WHO)—Today, Latin American researchers and global health leaders revealed preliminary results from the first-ever study to estimate the burden and costs of meningococcal disease in the region. The study found a need for improved surveillance and better understanding of meningococcal epidemiology and information on costs to help devise meningitis vaccination programs.
This new research was coordinated by the Sabin Vaccine Institute in partnership with the Pan American Health Organization (PAHO), the International Vaccine Access Center at Johns Hopkins University (JHU's IVAC) and the Centers for Disease Control and Prevention (CDC).
Dr. Ciro de Quadros, Executive Vice President of the Sabin Vaccine Institute in Washington, D.C., said, "Clearly, meningitis is a real health and economic burden in Latin America. Too many children are debilitated or die from this serious disease, yet it is preventable by vaccines. Our new research proves that we need to improve our strategies to fight meningococcal disease."
Dr. de Quadros spoke at the conclusion of the first Regional Meningococcal Symposium, convened by the Sabin Vaccine Institute and the Pan American Health Organization (PAHO), Regional Office of the World Health Organization (WHO). The symposium, which took place March 19 and 20 in Buenos Aires, brought together more than 150 researchers, vaccine experts, economists and others to evaluate the extent and cost of meningococcal disease and what obstacles impede its prevention through vaccination.
"Few diseases have as much power to cause panic among the population as meningococcal disease, said Dr. Marco Aurélio Sáfadi, Head of the Pediatric Infectious Disease Division at Sao Luiz Hospital in Sao Paulo, Brazil. "This is primarily because of its potentially epidemic nature. The rapid onset and high case fatality rates (10 - 20 percent), combined with substantial morbidity compound its health and economic impact. Our study notes that up to 20 percent of meningococcal disease survivors develop permanent disabilities including deafness, neurological deficit or limb amputation—only adding to the long-term economic impact of an outbreak."
The new research suggests healthcare costs associated with meningococcal diseases range from $4,500 to $6,500 (USD) per patient, and costs of controlling outbreaks have reached more than $3 million (USD) in some regions.
"The economic impact can vary widely across countries in the region," explained Dr. Dagna Constenla of the International Vaccine Access Center at Johns Hopkins University Bloomberg School of Public Health. "However, what is clear from our research is that meningococcal disease has significant costs for society and governments."
For example, one Florida community that reported seven confirmed meningococcal cases and vaccinated 13,000 persons spent $370,000 (USD) in intervention and management costs, or $53,000 (USD) per case. In Brazil, one community had a meningitis outbreak causing nine cases and spent $143,000 (USD) on investigation and outbreak management alone.
But the figures are much higher in large outbreaks. In 2007, Burkina Faso was hit with 25,000 cases of meningococcal disease and 1,700 related deaths, which resulted in direct costs of $3.5 million (USD), or 5 percent of its annual health expenditures. Costs of recent outbreaks in Oklahoma, Ohio, Brazil, Norway and Germany are largely unknown, the study said.
High incidence rates of meningococcal disease were reported in the countries with well-established disease surveillance systems including Argentina, Brazil, Chile and Uruguay, but low incidence rates were consistently reported in Mexico, Central America and the Caribbean.
"Given that we do not have a clear picture of the burden of this disease in Latin America, and we lack information on circulating serogroups, we have to further strengthen our epidemiological surveillance of this disease. Based on that information, we will generate the studies of epidemiology, cost-effectiveness, and opportunity costs needed to make evidence-based decisions in our Region," explained Dr. Cuauhtemoc Ruiz Matus, Coordinator of Comprehensive Family Immunization at PAHO.
Meningococcal meningitis, which infects the membranes of the brain and spinal cord, is a debilitating and potentially fatal disease that most severely affects children, adolescents and people living in overcrowded housing. In the Americas, it is most common in infants under 1 year of age. While the incidence of meningococcal disease varies widely among countries and over time, in recent years case fatality rates as high as 15 to 20 percent have been reported in several countries in Latin America and the Caribbean, the study noted.
The WHO estimates that 500,000 cases and 50,000 deaths of meningococcal disease occur annually worldwide. The new study concluded that more and better information is needed to help control outbreaks.
More information also is needed to devise vaccine programs, the study said: "Consideration of vaccination strategies to control meningococcal disease can only be made with a sufficient understanding of the changing epidemiology of meningococcal disease."
Currently, the only countries with routine immunization programs for meningococcal disease are Cuba and Brazil, though other countries are studying the options.
The two-day meeting where the study was presented featured sessions by global experts on the epidemiology of meningococcal disease, clinical presentation and treatment of the disease, cost analysis, immunity and meningococcal vaccines, and new strategies to prevent Meningitis B disease.
About Sabin Vaccine Institute
Sabin Vaccine Institute is a non-profit, 501(c)(3) organization of scientists, researchers, and advocates dedicated to reducing needless human suffering caused by vaccine preventable and neglected tropical diseases. Sabin works with governments, leading public and private organizations, and academic institutions to provide solutions for some of the world's most pervasive health challenges. Since its founding in 1993 in honor of the oral polio vaccine developer, Dr. Albert B. Sabin, the Institute has been at the forefront of efforts to control, treat, and eliminate these diseases by developing new vaccines, advocating use of existing vaccines, and promoting increased access to affordable medical treatments. For more information please visit www.sabin.org.
About the Pan America Health Organization
The Pan American Health Organization (PAHO) is an international public health agency with more than 100 years of experience in working to improve health and living standards of the countries of the Americas. It serves as the specialized organization for health of the Inter-American System. It also serves as the Regional Office for the Americas of the World Health Organization and enjoys international recognition as part of the United Nations system.