The Kent meningitis outbreak: what is happening and why? | Meningitis

What is meningitis?

Meningitis is a potentially fatal but rare disease caused by viruses and bacteria that trigger inflammation of the meninges, the protective membrane covering the brain. The urban epidemic is triggered by meningococcal bacteria found in the nose and throat of about 10% of the population. There are numerous types of meningococcal bacteria known as MenA, MenB, MenC, MenW, MenX and MenY. MenB is the culprit of the urban epidemic. Meningococcal bacteria have been living in humans for centuries, and public health officials have extensive experience with this disease.

Prof Andrew Pollard, from the University of Oxford, said: “This particular organism now has a history of several hundred years and we can certainly predict what factors played a role in the outbreak.”

With Covid, the situation was radically different. The pandemic was triggered by a new, highly contagious, airborne virus that public health officials were trying to understand on the fly. No country had dealt with Covid before and no one had prior immunity.

Who is at risk?

Meningitis is more common in infants, teenagers, and young adults than in the rest of the population. Babies are vulnerable because their immune systems are not fully developed. But teenagers and teenagers are among those most exposed to bacteria, largely due to living conditions and social behavior. Approximately 25% of the student population carries bugs and can potentially transmit them to others.

How is bacterial meningitis spread?

Meningococcal bacteria spread through close and prolonged contact. This can occur through close contact, such as kissing or sharing drinks or vaping, by living in the same house or student housing. People who spread the bugs do not tend to get sick, and only a minority who ingest the bugs develop meningitis.

It spreads much less easily than coronavirus. Covid patients’ respiratory tracts may be filled with the virus, and clouds of infectious virus particles can be released into the air by coughing and sneezing. Meningococcal bacteria do not survive well outside of saliva droplets or respiratory secretions and settle quickly when coughed. Dr D., a clinical lecturer at the London School of Hygiene and Tropical Medicine. “It’s much harder to get because it’s not available in the same way in the environment,” Eliza Gil said.

How fast is it spreading?

The Covid pandemic taught everyone about R values, which are the number of people an infected person usually infects. An R above one means cases are rising, below one means they are falling. Early in the pandemic, the R value for Covid was around three but has fallen with social distancing, isolation and vaccines. There are too few cases to calculate a reliable R value for the urban meningitis epidemic, but the virus spreads much less effectively than Covid or flu and the widespread rollout of antibiotics and vaccines will help bring the epidemic under control.

How common is meningitis?

It used to be much more common. In the 1990s, there were more than 2,000 cases a year in the UK, the majority of which were caused by MenC bacteria. Numbers have fallen significantly since 1999 with the introduction of the MenC vaccine and subsequent expansion of vaccines to cover MenA, C, W and Y. Since 2015 the NHS has offered the MenB vaccine for babies. It protects infants during their vulnerable first year or so, but is expected to decrease during adolescence. Those vaccinated against Men B as babies are unlikely to be protected in late adolescence.

Meningitis cases have fallen throughout the pandemic, falling below 100 in 2020-21. But the disease has since returned, reaching 378 cases in 2024-25. Other infections, such as influenza, respiratory syncytial virus (RSV), whooping cough, and gonorrhea, have rebounded similarly. In some cases, infections have returned strongly because people lost immunity to them in the pandemic.

The background rate of meningitis means public health authorities in England can expect to see an average of one case per day. It will be important to distinguish these from cases linked to the Kent outbreak.

Why do some people get seriously ill?

Serious diseases develop when bacteria enter the bloodstream, reach the fluid-filled areas around the brain and begin to multiply. It is unclear why this happens in some and not in others, but the type of bacteria and the person’s immunity are very important.

“We usually see cases in the first year or two after people go to college,” Pollard said. “They bring the strains from their cities and they come together in a central location where the strains start to mix. They end up finding someone who is not only susceptible to carrying the virus, but actually gets severe disease because they are susceptible, and that has to do with their background immunity.”

Historically, hyper-invasive strains of meningococcal bacteria come and go. A strain can cause serious disease for a decade, then disappear as people become immune, only to return a few decades later. The MenB strain behind the Kent outbreak has been circulating in the UK for about five years.

What caused the urban epidemic?

The outbreak was traced to Club Chemistry in Canterbury. This isn’t the first outbreak at a nightclub. In October 1997, three students at the University of Southampton died of meningitis after attending the same school. crowded and smoky club. Australia also reported cases linked to a nightclub. Such environments are suitable for the spread of infection. a study Going to pubs and clubs, kissing and smoking together increases the risk of meningococcal infection fourfold, British teenagers have found.

Gil suspected that the outbreak was triggered by a superspreader spreading large numbers of MenB bacteria. Those who are infected may be more susceptible if they have recently had a respiratory infection or if they smoke or vape; because this can make it easier for bacteria to adhere to the tissues lining the airways. As of Friday, 18 cases were confirmed and 11 were under investigation. There were two deaths.

Pollard said: “It’s a perfect storm of a particular organism, the host’s immunity and the event. I’m sure they’ll be looking at what might have happened that might have made it more likely to spread.”

How is the epidemic taken under control?

The public health response has been well rehearsed. People with meningitis are usually hospitalized. Others at risk, including those who attended the same nightclub, are offered antibiotics and the Bexsero MenB vaccine. Antibiotics aim to kill bugs in the nose and throat before they cause serious illness or spread to others. The MenB vaccine aims to protect against meningitis if people become infected in the coming weeks. But it doesn’t stop the bugs from infecting the nose and throat, so people can still spread the bugs. The vaccine is given twice a month and protection peaks after five weeks.