Prevention of meningitis with vaccines

Acute meningitis is life-threatening and presents with increased morbidity and mortality. A distinguishing characteristic exists between bacterial meningitis and the more common viral meningitis. With the increased use of the said conjugate vaccines, the annual occurrences of bacterial meningitis in the US decreased from the earlier 1.9 down to1.5 cases per 100,000 persons between the years 1998 and 2003, with a total mortality rate of 15.6%. The frequency rates in developing countries, however, continue to hover around the higher numbers.

In the year 2009, around 88,000-odd cases of meningococcal disease (assumed) were reported in the countries in the “meningitis belt,” which resulted in close to 5,000-5,500 deaths. The worst hit regions and countries were Niger and Nigeria where the combined fatalities and cases were close to 3,000 deaths and 69,500 cases. Between the year 2003 and 2007, 10% of the epidemic cases were due to W135 and 87.8% were due to serogroup A.

Prevention with meningitis vaccines
Conjugate vaccines administered in early childhood for the following – H. influenzae types S and B pneumonia have effectively decreased the occurrence of bacterial meningitis in both children and adults. While, the overall occurrences of pneumococcal meningitis have reduced with the administration of the said conjugate vaccine, the fraction of cases of meningitis caused due to the nonvaccine serotypes has gone up. Also, the number of isolates that were insusceptible to cefotaxime and penicillin has also gone up. The newer form of conjugate vaccine against Neisseria meningitides is suggested to be administered to all persons with complement component deficiencies, travelers to meningococcal disease endemic regions, and children between the ages of 11 and 18 years.

This vaccine is active against serogroups A, C, W135, and Y, but not serogroup B. Patients with asplenia (anatomic or functional) should be vaccinated against H. influenzae, pneumococcal and meningitis vaccine. Patients who are in the hospital suffering from meningitis of an uncertain etiology or with the N. meningitides infection will need droplet precautions for the first one day of the treatment, or until the latter can be eliminated.

Currently available meningitis vaccines
Meningococcal bacteria can cause meningitis and septicemia (meningococcal disease). Vaccines are now available for all the five groups – A, B, C, W, and Y, which are the common disease causing agents. These include Men B, Men C, Men ACWY, Hib, Pneumococcal conjugate vaccine (PCV), Pneumococcal polysaccharide vaccine (PPV), MMR, BCG and MenACWY for travel. It is always beneficial to consult the doctor before you take any vaccinations.

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