The Central Hospital for Tropical Diseases admitted a 52-year-old patient from Lao Cai with purplish-red hemorrhages on the chest, abdomen, and both legs, experiencing septic shock due to meningococcal infection. The patient's history included consuming pork before symptom onset, leading lower-level doctors to suspect streptococcus suis infection.

Doctor of Medicine, First Class Specialist Bach Thi Chinh, Medical Director of the VNVC Vaccination System, stated that septic shock caused by meningococcal bacteria and streptococcus suis infection are often confused. Both diseases present with similar symptoms and can lead to severe sepsis accompanied by a systemic inflammatory response. Once in the bloodstream, both types of bacteria damage blood vessels and cause blood clotting disorders, resulting in septic shock, multi-organ failure, and the appearance of hemorrhagic necrotic patches.

Additionally, both bacteria can cause acute meningitis, characterized by non-specific symptoms such as high fever, severe headache, nausea, stiff neck, and altered consciousness.

People with meningococcal disease must receive high-dose vasopressors at the Central Hospital for Tropical Diseases. Photo: BVCC

According to Doctor Chinh, meningitis caused by streptococcus suis can be distinguished from meningococcal meningitis by specific symptoms like hearing loss, tinnitus, or sudden deafness, which appear early in the initial days. However, for the general public, identifying the two diseases through clinical manifestations is challenging due to their many similarities. Doctors rely on the characteristics of the petechial rash (if present) and conduct microbiological tests, such as culture or molecular biology techniques, to accurately identify the causative agent.

Both meningococcal disease and streptococcus suis infection are urgent medical conditions due to their rapid progression, high mortality rates, and severe neurological sequelae. Streptococcus suis causes death in 10-30% of cases, with common sequelae including permanent deafness, prolonged vestibular disorders, limb weakness, and cognitive impairment. For meningococcal disease, 50% of patients will die if left untreated. Even with aggressive diagnosis and treatment, the mortality rate remains 8-15% and can reach 40% in cases of fulminant septicemia, leaving severe sequelae such as limb amputation, hearing loss, neurological disorders, or memory impairment.

"Therefore, individuals experiencing symptoms like fever, vomiting, and severe headache should seek immediate medical attention for timely detection and treatment", Doctor Chinh advised.

People receiving disease prevention vaccines at the VNVC Vaccination System. Photo: Dieu Thuan

Regarding transmission, Doctor Chinh explained that the two diseases have different routes. Meningococcal bacteria spread through respiratory droplets during close contact with infected individuals or asymptomatic carriers. In contrast, streptococcus suis is not transmitted from person to person but through direct contact with blood or pork, or by consuming undercooked pork or raw blood pudding. Pigs can transmit the infection to humans even if they show no symptoms.

Given the current winter-spring transition and Tet Nguyen Dan (Lunar New Year) holiday, Doctor Chinh recommends that people proactively prevent both diseases. Meningococcal bacteria spread more easily in cold, humid weather or crowded environments. Meanwhile, streptococcus suis is often transmitted through eating undercooked pork, raw blood pudding, or fermented pork roll made from raw meat, or direct contact with the blood or meat of infected pigs, especially in areas where it is customary to slaughter pigs for the Tet holiday.

To prevent illness, people should ensure pork is thoroughly cooked, avoid consuming raw blood pudding or fermented pork roll made from raw meat, refrain from buying and consuming pork from unknown sources, and wear gloves and protective gear when handling uncooked pork. Additionally, everyone should wash hands frequently with soap, rinse their mouth and throat with common antiseptic solutions, and ensure good ventilation in homes and workplaces. If suspected symptoms appear, seek medical examination or immediately inform the nearest health authority, and never self-treat.

There is currently no proactive vaccine for streptococcus suis. However, meningococcal disease can be prevented with five types of vaccines available through vaccination services, protecting against five common human serogroups: A, B, C, Y, W-135. The group B vaccine is administered to children from two months to adults aged 50. Vaccines for groups B and C are given from six months to 45 years. Three vaccines for groups A, C, Y, W-135 can be given as early as six weeks of age, with no upper age limit for adults.

Meningococcal vaccination is also one of the preventive measures recommended by the Ministry of Health. People should get vaccinated at qualified healthcare facilities to ensure safety and effectiveness.

Furthermore, meningococcal vaccination for high-risk groups is widely adopted in many countries. In the UK, the implementation of A, C, Y, W vaccines for adolescents significantly reduced incidence rates, leaving only sporadic cases; group B vaccination for young children reduced the risk of disease by approximately 75% compared to unvaccinated groups.

Binh An