Bacterial meningitis primary prevention: Difference between revisions

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==Overview==
==Overview==
Primary preventive measures which may help prevention of bacterial meningitis may include vaccination against meningococcal, pneumococcal and hemophilus influenza infection. Vaccination does not provide 100 percent protection. However, it may help to reduce the chances of acquiring the infection significantly especially in patient population who is immunocompromised or at extremes of age. Other preventive measures may include antibiotic chemoprophylaxis for patients exposed to Neisseria meningitides and Hemophilus influenza type b.
==Primary prevention==
==Primary prevention==
Primary preventive measures to prevent bacterial meningitis include the following
Primary preventive measures to prevent bacterial meningitis include the following

Revision as of 17:05, 5 January 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

Primary preventive measures which may help prevention of bacterial meningitis may include vaccination against meningococcal, pneumococcal and hemophilus influenza infection. Vaccination does not provide 100 percent protection. However, it may help to reduce the chances of acquiring the infection significantly especially in patient population who is immunocompromised or at extremes of age. Other preventive measures may include antibiotic chemoprophylaxis for patients exposed to Neisseria meningitides and Hemophilus influenza type b.

Primary prevention

Primary preventive measures to prevent bacterial meningitis include the following

Vaccination

There are three types of vaccination available for prevention of bacterial meningitis from three bacterial agents. These include:[1][2][3][4][5]

Vaccinations
Type of Vaccination Recommendations
Pneumococcal[6]
  • Pneumococcal conjugate vaccine(PCV13)
  • Pneumococcal polysaccharide vaccine(PPSV23)

Pneumococcal conjugate vaccine

  • Children under 2 years of age
  • Older people >65 years of age
  • Individuals 2 to 65 years of with medical conditions such as patients with CKD, cochlear implants, asplenia

Pneumococcal polysaccharide vaccine

  • All adults 65 years or older
  • People 2 to 65 years with certain medical conditions such as diabetes and chronic heart, lung or liver disease
  • Adults 19 to 64 years who smoke cigarettes
Meningococcal[7]
  • Meningococcal conjugate vaccines
  • Meningococcal polysaccharide vaccine
  • Serogroup B meningococcal vaccines
  • Children and adolescents age 11 through 18
  • Military recruits
  • College students living in dorms
  • Splenectomy or splenic damage
  • Person having complement deficiency
  • People travelling to endemic areas such as Africa
Hemophilus influenza type b (Hib)[8][9]
  • Hib conjugate vaccine
  • All children younger than 5 years of age
  • People at increased risk of invasive hib infection such as asplenia, HIV infection
  • Unvaccinated older individuals or adults with medical conditions [10]

Other preventive measures

Other preventive measures which may help preventing meningitis may include:[11][12][13][5]

Other preventive measures
Preventive strategy Recommendations
Avoidance of risk factors
  • Decreased to no exposure to patients suffering from meningitis
  • Following vaccination schedule if at high risk of acquiring the disease
  • Appropriate chemoprophylaxis in case of exposure to the index case
Droplet precaution
  • People exposed to patients within three to six feet of the patient should wear surgical mask
  • Doors of the room where patient resides should be kept open
Chemoprophylaxis
  • Chemopropylaxis required for suspected cases of meningococcal and hemophilus infection
  • All household members
  • Roomates or intimate contacts
  • Child care workers
  • People directly exposed to patient's respiratory or oral secretions
  • Airline travelers seated close to affected person > 8 hours

References

  1. Cohn AC, MacNeil JR, Clark TA, Ortega-Sanchez IR, Briere EZ, Meissner HC; et al. (2013). "Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP)". MMWR Recomm Rep. 62 (RR-2): 1–28. PMID 23515099.
  2. Robinson CL, Advisory Committee on Immunization Practices (ACIP), ACIP Child/Adolescent Immunization Work Group (2016). "Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years--United States, 2016". MMWR Morb Mortal Wkly Rep. 65 (4): 86–7. doi:10.15585/mmwr.mm6504a4. PMID 26845283.
  3. Makwana N, Riordan FA (2007). "Bacterial meningitis: the impact of vaccination". CNS Drugs. 21 (5): 355–66. PMID 17447825.
  4. English P (2013). "Vaccination against meningitis B: is it worth it?". Drugs Context. 2013: 212246. doi:10.7573/dic.212246. PMC 3884741. PMID 24432035.
  5. 5.0 5.1 Prasad K, Karlupia N (2007). "Prevention of bacterial meningitis: an overview of Cochrane systematic reviews". Respir Med. 101 (10): 2037–43. doi:10.1016/j.rmed.2007.06.030. PMID 17706408.
  6. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/pcv13.html, Accessed on Jan 5, 2017
  7. https://www.cdc.gov/meningococcal/vaccine-info.html, Accessed on 5th Jan, 2017
  8. https://www.cdc.gov/vaccines/hcp/vis/vis-statements/hib.html, Accessed on 5th Jan, 2017
  9. Briere EC, Rubin L, Moro PL, Cohn A, Clark T, Messonnier N; et al. (2014). "Prevention and control of haemophilus influenzae type b disease: recommendations of the advisory committee on immunization practices (ACIP)". MMWR Recomm Rep. 63 (RR-01): 1–14. PMID 24572654.
  10. https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6301a1.htm, Accessed on 5th Jan, 2017
  11. Schaad UB (1984). "Chemoprophylaxis for the prevention of bacterial meningitis". Infection. 12 Suppl 1: S65–71. PMID 6530293.
  12. Shapiro ED (1985). "Prophylaxis for bacterial meningitis". Med Clin North Am. 69 (2): 269–80. PMID 3990434.
  13. Schwartz B, Al-Tobaiqi A, Al-Ruwais A, Fontaine RE, A'ashi J, Hightower AW; et al. (1988). "Comparative efficacy of ceftriaxone and rifampicin in eradicating pharyngeal carriage of group A Neisseria meningitidis". Lancet. 1 (8597): 1239–42. PMID 2897515.


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