A young child was admitted to the Ajaccio hospital center on Friday April 19 for purpura fulminans. It belongs to the family of Invasive Meningococcal Infections (IIM), indicates the ARS. Grouped under the acronym IMM, they are caused by bacteria which can have fatal or serious consequences. Moreover, the boy’s state of health having been considered worrying, the little one was transferred to Marseille, by medical plane.
Purpura fulminans is a rare infectious disease preferentially affecting children and adolescents without comorbidity, characterized by the association of a state of septic shock – which often leads to death – and purpura (red or purple spots on the skin ). In the absence of rapid and effective treatment, death occurs within the first 24 hours in 70% of patients. The two main bacteria responsible are meningococcus and pneumococcus.
A high risk of mortality
Purpura fulminans presents as a serious, sometimes fatal, form of severe sepsis: a condition that occurs when the immune system has an extreme reaction to an infection. Also, if the bacteria responsible for purpura fulminans fortunately turn out to be reactive to antibiotics, the prognosis of affected patients remains serious, with mortality in intensive care reaching 41% and a significant risk of long-term after-effects in survivors.
Purpura fulminans is so called because it tends to spread quickly and widely throughout the body. In France, the main serogroups responsible for infection are B and C. Other strains are circulating, which are W, A and Y. The list of vaccines can be found on vaccination-info-service.fr .
Compulsory and recommended vaccination
Public Health France thus recalls the measures put in place in France to protect against it. Concerning serogroup C meningococci, vaccination is compulsory for infants born from January 1, 2018 and recommended for unvaccinated people up to the age of 24. The first dose should be given at the age of 5 months.
To combat serogroup B meningococci, vaccination is not obligatory but recommended in all infants, with a 3-dose schedule (at 3; 5 and 12 months), as well as in unvaccinated children up to age of 2 years.
Less than 100 cases in France each year
This is a rare pathology. In fact, fewer than 100 cases of purpura fulminans are recorded each year in France. In 2023, 560 cases of invasive meningococcal infections (IMM) of all categories were declared, reports Public Health France, an increase of 72% compared to 2022. The presence of purpura fulminans was reported in 18% of cases from IIM.
Public Health France suggests that this post-Covid resurgence could be explained by the drop in immunity in the population less exposed to meningococci during the pandemic, but also by the return of respiratory viruses (in particular influenza) which can promote infections. bacterial invasives.
As a reminder, the most suggestive symptoms are violent headaches (headaches), accompanied by fever; sensitivity to light (photophobia); neck stiffness; aches and fatigue; red or purplish subcutaneous spots (purpura) on the body.