Dr. N. Ashok Viswanath
Infectious Diseases
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I would like to know what happens if a healthy person with no factor-H deficiency acquires an invasive strain of meningococcus. Do they go on to develop meningitis or not? It is well known that in ten people, just one will develop meningitis, the rest will be colonized in the nose and throat with the virulent strain, but the bacteria will not pass the barrier to blood. So this healthy person with no complement deficiency, who acquires the invasive strain of meningococcus, will develop meningitis or not? Kindly give your opinion.
Hello,
Welcome to icliniq.com.
A healthy person with no complement deficiency disorders like Factor-H deficiency are less likely to develop the infection due to meningococcus (Neisseria meningitidis). It is not only Factor-H deficiency but also other complement protein deficiency such as C1, C2, C4, Factor-D, Factor-I, properdin, membrane attack complex which can increase the susceptibility to infection by capsulated organisms such as Neisseria meningitidis. It is not only these complement protein deficiency that is going to increase the chance of colonized pathogen to cause infection, but other factors like age, comorbid conditions like diabetes, malnutrition, use of steroids, spleen removal surgery can increase the chance of infection from colonized pathogen like meningococcus. It is always better to receive meningococcal prophylaxis in the form of a vaccine to avoid the infection and, to some extent, colonization.
I hope this was helpful.
Patient's Query
Hi doctor,
Thank you.
I feel like I have understood for the first time. I now want to explain why I have this question. I have a 2 and a half years old daughter. Here we have approximately 76 cases of meningococcus meningitis per year at 20,000,000 inhabitants. The B-strain causes 70% of those. We do have vaccines. I am interested in Bexsero, the vaccine for men-B. It is an optional vaccine. I want you to know I am pro vaccines, and my daughter had all the compulsory vaccines. But this is an optional one, and it was introduced five years ago. So I worry about the small chance that she gets serious side effects. That is why I am trying to understand how all this works. Here they vaccinate infants below one year because then it is the highest risk. But I am not sure how long this protection lasts. If it lasts only three years, then at 4-year-old, the vaccinated children have the same risk as unvaccinated ones. Or does humoral immunity lasts forever? If I do not send my daughter in collectivity until 5-year-old, will the danger have passed by then? Or should I risk and vaccinate her nevertheless? Kindly give your opinion.
Hello,
Welcome back to icliniq.com.
My advice will be, It is better to vaccinate your child. After many years after vaccination, though the immunity comes down, the memory of T-lymphocytes formed during the vaccine immunity process remains intact for many decades, which gives atleast some immunity for those who got vaccinated than those who did not get vaccinated. It will prevent us from going into a severe form of infection and complication by meningococcus.
I hope this was helpful.
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Infectious Diseases
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