Meningitis vaccines

In Mger, fake meningitis vaccines, administered during an epidemic in which more than 26 700 people had contracted the disease, led to the deaths of 2 500 people ). Substandard and counterfeit products are not only a problem in developing countries, but in developed countries as well (7,8,9,10,11). 

Fake meningitis vaccine in Niger (editorial). Scrip, 23 August 1996, 2157 12. 

Mr JD weighs 70 kg, is a smoker and has an unremarkable medical history. He takes occasional caffeine tablets prior to examinations but otherwise takes no regular medication. He remembers receiving a meningitis vaccine at school. On arrival at A E, his vital signs are recorded as follows ... 

A series of vaccines against Haemophilus influenzae, started at two months of age, has greatly reduced the incidence of that form of meningitis. Vaccines also exist against Neisseria meningitidis and Streptococcus pneumoniae bacteria, but these vaccines are only recommended for those people who have particular susceptibility to those organisms, due to certain immune deficiencies, lack of a spleen, or sickle cell anemia. 

Lieberman JM, Greenberg DP, Ward JI. Prevention of bacterial meningitis Vaccines and chemoprophylaxis. Infect Dis Clin North Am 1990 4 703-729. 

There are a number of practical problems involved with using polysaccharides as vaccines as there are frequently too many different chemotypes for it to be practicable to prepare a vaccine. In some cases a limited number of serotypes are the dominant cause of infection and it may then be possible to produce vaccines. A major problem is the poor immune response elicited by polysaccharide antigens, which may in some cases be improved by chemical modification. This is (fie case for vaccines for Haemophilus influenzae type b (a causative agent of meningitis), where the antigenicity of the polysaccharide can be increased by coupling to proteins. 

S. pneumoniae, N. meningitidis, and H. influenzae type b dramatically. Prior to the availability of Hib conjugate vaccines, Hib meningitis or other invasive disease was documented in 1 in 200 children by the age of 5 years.5 Widespread use of the Hib vaccine has reduced the incidence of invasive Hib disease by 99% and has shifted the age distribution of bacterial meningitis to older age groups (from 15 months in 1986 to 25 years in 1995).1,6 Recent data indicate that routine use of the 7-valent... 

Prior to the introduction of the Hib conjugate vaccine, H. influenzae type b was the most common cause of bacterial meningitis in the United States.5 Routine inoculation of pediatric patients against Hib since 1991 has reduced the incidence of invasive Hib disease (i.e., meningitis and sepsis) in children younger than 5 years of age by 99%,6 with mortality from Hib... 

Haemophilus influenzae is a bacterial respiratory pathogen that causes a wide spectrum of disease ranging from colonization of the airways to bacterial meningitis. It causes considerable morbidity and mortality, especially in children less than 5 years of age. H. influenzae is either encapsulated or unencapsulated. The encapsulated strains can be further differentiated into six antigenically distinct serotypes, a through f. H. influenzae type b was primarily found in cerebrospinal fluid and blood of children with meningitis, while the unencapsulated strains were found in the upper respiratory tract of adults. Before the introduction of the vaccine, H. influenzae was responsible for 20,000 to 25,000 cases of invasive disease annually and was the most common cause of bacterial meningitis. Since the introduction of the vaccine, invasive disease due to H. influenzae type b has been nearly eliminated. 

Streptococcus pneumoniae is the most common bacterial cause of community-acquired respiratory tract infections. S. pneumoniae causes approximately 3000 cases of meningitis, 50,000 cases of bacteremia, 500,000 cases of pneumonia, and over 1 million cases of otitis media each year. The increasing prevalence of drug-resistant S. pneumoniae has highlighted the need to prevent infection through vaccination. Both licensed pneumococcal vaccines are highly effective in preventing disease from the common S. pneumoniae serotypes that cause human disease. 

Second, we described the successful outcomes of Ap immunotherapy in mutant mice with Ap amyloidosis. Unfortunately, in humans, although Phase 1 trials with Ap peptide and adjuvant vaccination were not associated with any adverse events, Phase 2 trials were suspended because of severe adverse reactions (meningoencephalitis) in a subset of patients [79,90]. The pathology in a single case, consistent with T-cell meningitis [90], was interpreted to show some clearance of Ap deposits, yet these regions... 

In the past, H. influenzae was the most common cause of meningitis in children 6 months to 3 years of age, but this has declined dramatically since the introduction of effective vaccines. 

A further type of vaccine included in the subunit category is the capsular polysaccharide vaccines, for example, those against Haemophilus influenzae and meningococcal meningitis. In this case an extract of the polysaccharide outer capsule of the bacterium is used as a vaccine and is sometimes conjugated to protein to... 

Anthrax A (Bacillus anfhracis) Animals— herbivores 1-5 days No Standa d (invasive procedures should be avoided) Inhalation— fever, dry cough,resp distress, meningitis cutaneous-skin ulcer Dea h may occur about 24-36 h post exposure Ciprofloxacin, doxycycline A vaccine is available... 

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