Prevention of bacterial meningitis:
Common symptoms that can occur following vaccination, for example, redness and swelling around the injection site and fever are natural reactions of the body’s immune system. These symptoms will usually subside in a very short period of time, and are a good indicator of a successful vaccination.
The following vaccines provide protection
against three major bacteria that cause
meningitis. These vaccines are offered to all
infants in the UK as part of the Childhood
Hib Vaccine - Haemophilus influenzae type b (Hib)
bacteria can cause meningitis and septicaemia. Before the vaccine was
introduced in 1992, Hib was the leading cause
of meningitis in children under 5 years of age,
with around 800 cases and 25 deaths reported
Cases of Hib meningitis are now rare, with
around 50 cases reported each year. Hib is part
of the combined vaccine that protects against
Diphtheria, Tetanus, Pertussis (whooping cough),
Polio and Hib. This combined vaccine is offered
to babies at 2, 3, and 4 months of age, with a
booster dose given at around 12 months of age. The booster vaccine is a combined vaccine for
Hib and meningococcal group C (MenC).
Men C Vaccine - Meningococcal group C (Men C) -
Meningococcal bacteria can cause meningitis
and septicaemia. There are five groups; A, B, C,
W135 and Y which commonly cause disease.
Since the introduction of the Men C vaccine in
1999 cases of group C disease have fallen by
around 90% in all age groups.Men C vaccine is offered to babies at 3 and 4 months of age, with a booster dose given at around 12 months of age. The booster vaccine is a combined vaccine for Hib and Men C.
There is no vaccine to prevent meningococcal group B disease, which is the most common cause of bacterial meningitis in the UK.
Pneumococcal - pneumococcal bacteria can cause meningitis, and less commonly septicaemia. There are over 90 different strains of pneumococcal bacteria. The risk of pneumococcal meningitis is highest in children under 18 months of age. Two vaccines are currently available to prevent pneumococcal disease:
A Pneumococcal Conjugate Vaccine (PCV) is available as part of the Childhood Immunisation Programme. It is routinely offered at 2, 4, and 13 months of age. PCV protects against 7 different types of pneumococcal bacteria which account for around 75% of invasive disease (including meningitis) in the UK under 5s.
A Pneumococcal Polysaccharide Vaccine (PPV) is also available. This protects against 23 strains of pneumococcal bacteria, but only has a limited period of protection, and is not effective in the under 2s. This vaccine is routinely offered to people aged 65 years and over. Pneumococcal vaccinations are recommended for adults and children who are at increased risk of pneumococcal disease, for example, those with asthma, chronic heart disease, diabetes mellitus and those with cochlear implants. Anyone who has had pneumococcal disease, including meningitis, should actively seek vaccination.
Treatment of bacterial meningitis:
Initial Blind therapy – transfer patient immediately to hospital. If bacterial meningitis is suspected then benzyl penicillin should be given via slow intravenous injection or by infusion at 2.4g every 4hours. Cefotaxime may be used as an alternative if patient has a penicillin allergy and chloramphenicol can be used if the patient is allergic to both penicillin and cephalosporins.
When the patient has been administered to the hospital the CSF and blood tests should give a confirmation of the pathogen which has caused the case of meningitis. The treatment can be then adjusted so that it is specific to the pathogen:
|Type of menigitis
||Benzylpenicillin or Cefotaxime. Treat for at least 5 days (if hypersensitivity to penicillins or cephalosporins substitute to chloramphenicol)
||Cefotaxime. Treat for 10-14 days
Cefotaxime. Treat for at least 10 days