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Put bacterial meningitis vaccines on back-to-school checklist

Baylor College of Medicine News Aug 16, 2018

Bacterial meningitis is serious and can be life threatening, but in most cases it can be prevented with safe and effective vaccines, said an infectious disease expert at Baylor College of Medicine.

“Vaccines are available against all three of the major bacteria that cause bacterial meningitis. Since the vaccines for infants have been introduced, the number of meningitis cases has been reduced dramatically,” said Dr. Sheldon Kaplan, professor of pediatrics and head of the pediatric infectious disease section at Baylor.

It is important to be aware of the various types of bacterial meningitis—meningococcal, pneumococcal and Haemophilus influenzae type b, or Hib, because each requires a different vaccine and can affect people at a different age.

Meningitis is an inflammation of the membranes over the spinal cord and brain. It can be caused by bacteria, the more damaging form, or viruses, which are usually associated with a complete recovery and less severe symptoms, Kaplan said.

“Bacterial meningitis can be treated with antibiotics but can be life threatening and leave serious side effects such as permanent brain damage and hearing loss, despite optimal treatment. Thus, it is far better to prevent this infection, if possible,” he said.

Kaplan provides an overview of the types of bacterial meningitis and those most at risk for each:

Pneumococcal and Hib

Children less than 2 years old have the highest risk for pneumococcal and Hib meningitis (peak from 6 to 24 months).

In this young group, the first signs of the disease are not specific and progress over a day or more. Both forms may start with a fever, runny nose and decreased appetite, energy and activity that progressively get worse. Vomiting often occurs, and older children may complain of headaches.

Vaccines for protection against bacterial meningitis caused by pneumococus or Hib are a part of the routine, recommended childhood vaccine schedule starting at 2 months.

Families should discuss the vaccine schedule with the child's pediatrician or family physician and get the doses on time to be protected as soon as possible. The vaccines have been studied carefully and are very safe.

Meningococcus

The third cause of bacterial meningitis is meningococcus, of which there are several strains. Children are most at risk for meningococcal meningitis during the first year of life, but there is another peak in incidence and risk in adolescents 15 to 18 years.

Symptoms of meningococcal meningitis develop very quickly and can begin with fatigue, headache, muscle aches, a purple rash on the legs then arms and, within hours, shock and coma.

The meningococcal vaccine is routinely recommended at age 11 years for three of the more common types of meningococcal meningitis in the United States. A newer meningococcal vaccine is now available to prevent another type of meningococcal meningitis and is approved for children starting at 16 years old. Families may wish to discuss with their student’s physician whether and when to administer this new meningococcal vaccine.

Texas is one of several states that require children to have the vaccine before entrance to middle school. In addition, students entering college are required to show proof meningococcal vaccination or a booster dose during the 5-year period prior to enrolling.

Some children and adults with underlying medical conditions and compromised immune systems may need more regular doses of the vaccines. For example, children and adults who do not have a spleen may need the vaccines every 5 years.

There is no vaccine or treatment for viral meningitis but recovery is typical.

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