Prevention against infectious diseases key to healthy aging: say local experts in KSA

Decreased birth rates and longer lifespans indicate that the global population is aging, although rates of aging differ between countries. In 2010, the proportion of the population aged >60 years in the general Arab Region was 7%, and this proportion is expected to rise to 19% by 2050 for the region as a whole.1

Even if you were vaccinated at a younger age, the protection from some vaccines can wear off overtime. As you get older, you may also be at risk for infections due to your job, hobbies, travel, or health conditions; some of these infections are vaccine-preventable diseases.[i]

“Too many adolescents and adults are not receiving the vaccines that they need to maintain their protection and keep healthy throughout life. Healthy individuals and health-care providers  need to understand the vital importance of keeping immunizations up to date throughout a person’s lifetime.[ii] As Centre for Disease Control and Prevention recommends people with asthma, COPD, diabetes, smokers and those suffering from heart disease or are over 65 years old should be vaccinated against pneumococcal disease6” says Dr. Majid Alshamrani, Deputy Executive Director of Infection Prevention and Control Program at the Ministry of National Guard Health Affairs.

Individuals who carry S. pneumoniae in their nasal passages may potentially expose people who are not vaccinated to the risk of infection through direct hand contact or via respiratory droplets that are sneezed, coughed, or exhaled containing S. pneumoniae bacteria. [iii] The majority of new cases in older adults present with severe pneumonia. A case of pneumonia in which bacteria is found in the blood is known as invasive pneumococcal disease (IPD). IPD is associated with high case-fatality rates of 15—25% among elderly adults.1

Meningococcal disease remains an important cause of endemic and epidemic disease in many MENA “Middle East and North Africa” countries. The epidemiology of meningococcal disease in MENA is affected by the proximity of the region to the African meningitis belt, which extends from Senegal in the west to Ethiopia in the east. In this region, meningococcal disease incidence rates are several times higher than those seen in industrialized countries, sometimes exceeding 1000 cases per 100 000 population due to N. meningitidis outbreaks.[iv]

“Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the thin lining that surrounds the brain and spinal cord. It can cause severe brain damage and is fatal in 50% of cases if untreated. The bacteria are transmitted from person to person through droplets of respiratory or throat secretions from carriers. Close and prolonged contact – such as sneezing or coughing on someone, or living in close quarters (such as a dormitory, sharing eating or drinking utensils) with an infected person (a carrier) – facilitates the spread of the disease[v],” added Dr.Majdy Idrees, Consultant Pulmonologist and Head of Pulmonary Division at Riyadh Armed Forces Hospital.

Saudi Arabia has a special interest in N. meningitidis due to the Hajj and Umrah pilgrimages, which bring large numbers of people together, often in crowded conditions and have resulted in epidemics, such as in 2000 and 2001, which occurred during March and April—the Hajj seasons at that time. Obtaining visas for these pilgrimages is now dependent upon proof of vaccination.[vi] The largest meningococcal outbreak among pilgrims occurred in 1987 with meningococcal serogroup A affecting pilgrims in Mecca and internationally. Visitors arriving for the purpose of Umrah or pilgrimage (Hajj) or for seasonal work are required to submit a certificate of vaccination against meningitis issued no more than 3 years and no less than 10 days before arrival in Saudi Arabia.[vii]

For Umrah & Hajj, Saudi Arabia’s Ministry of Health has laid down compulsory regulation for meningococcal meningitis.[viii] Although meningococcal vaccination is a compulsory requirement for all pilgrims attending Hajj, compliance is not 100%.[ix]

Centre for Disease Control and Prevention recommends vaccination against meningococcal disease for adults who are 56 years and older, have complement component deficiency, have a damaged or removed spleen, a microbiologist exposed to N. meningitidis, travelling or residing in countries where the disease is common, part of population identified to be at risk, a first year college student living in a residence hall and a military recruit.11 Vaccination against meningococcal meningitis has been made mandatory by Ministry of Health in Kingdom of Saudi Arabic for all Hajj and Umrah travelers and visitors from African meningitis belt[x].

Take steps to protect yourself and your loved ones.6

Staying healthy is a priority for all of us - and it's especially critical for those with chronic conditions. Vaccination provides the best protection against diseases that could result not only in serious health problems, but missed work, medical bills, and not being able to care for your family. Take the following steps to make sure you have the best protection.

• Step 1: Learn about vaccines recommended for adults based on age and other factors.
• Step 2: Talk with a healthcare professional about which vaccines are right for you.
  • Your doctor or other healthcare professional can advise you on which vaccines you need and why – as well as which vaccines may not be right for you based on certain factors such as allergies to vaccine ingredients or health conditions.
• Step 3: Get vaccinated.
• Step 4: Keep track of your vaccinations and make sure you stay up-to-date.
  • Make sure to keep track of your vaccines to ensure you are up-to-date and have maximum protection against vaccine-preventable diseases.
• Step 5: Encourage your friends and loved ones to get vaccinated.
  • All adults need immunization to protect them from getting and spreading serious diseases. After getting your vaccinations, talk to your friends and loved ones about getting protected.

[i] Adult Vaccination: An Important Step in Protecting Your Health. CDC Features. Available at: http://www.cdc.gov/features/VaccinesChronicConditions/. Page last updated: September 23, 2015.

[ii] WHO’s World Immunization Week 2016. Close the Immunization Gap. Campaign Toolkit. Available at: http://www.who.int/campaigns/immunization-week/2016/toolkit-en.pdf?ua=1

[iii] Pneumococcal Disease. Centers for Disease Control and Prevention (CDC). CDC Pink Book. 2011; 16:233-248

[iv] Mehmet Ceyhan a, Sameh Anis b, Latt Htun-Myint; Meningococcal disease in the Middle East and North Africa: an important public health consideration that requires further attention; International Journal of Infectious Diseases 16 (2012) e574–e582.

[v] World Health Organization - Meningococcal meningitis; Fact sheet N°141; Updated November 2015.

[vi] Meningococcal: Who Needs to Be Vaccinated? CDC. Available at: http://www.cdc.gov/vaccines/vpd-vac/mening/who-vaccinate.htm. Page last updated: October 22, 2015.

[vii] Memish ZA. The Hajj: communicable and non-communicable health hazards and current guidance for pilgrims. Article. Rapid Communications. Eurosurveillance. 2010

[viii] Health Regulations for Travelers to Saudi Arabia for Umrah& Pilgrimage (Hajj)-1435. 2014; http://www.moh.gov.sa/en/Hajj/Pages/HealthRegulations.aspx

[ix] Memish Z A. Assiri A M. Hussain R. et all. Detection of Respiratory Viruses Among Pilgrims in Saudi Arabia During the Time of a Declared Influenza A(H1N1) Pandemic. J of Travel Med. 2011; 19: 15–21

[x] Health Regulations for Travelers to Saudi Arabia for Umrah& Pilgrimage (Hajj)-1435 (2014). Updated in 2014. http://www.moh.gov.sa/en/Hajj/Pages/HealthRegulations.aspx