Meningitis and Encephalitis

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Prevention

There are vaccines available for Haemophilus influenzae type b, some types of Streptococcus pneumoniae, and Neisseria meningitides Type C. These can all cause meningitis and the vaccines are part of the routine immunisation schedule for children. Widespread vaccination of children has drastically reduced the incidence of Haemophilus influenzae type b as previously stated. The introduction of the meningitis type C vaccine has decreased the amount of meningitis caused by this strain. As a result, most cases of meningococcal meningitis in the UK currently are caused by Type B. Meningitis type C strains are more common in older children whereas type B seems to affect younger children particularly the under 5s. The UK’s first vaccine against Meningitis B (meningococcal group B) has recently been licensed for use in this country in ages 2 months and over. The new vaccine, called Bexser is not currently part of the UK children vaccination schedule. The Joint Committee on Vaccination and Immunisation (JCVI), who advise health ministers on vaccination, are currently considering which age groups should receive the vaccine if it is introduced into the routine schedule and guidance is expected in summer 2013. It is currently not available privately but is expected to be from the middle of 2013. It is not always possible to prevent encephalitis because it can be a rare complication of a relatively common infection. The NHS choices website advice however is that the most effective way to reduce your risk of encephalitis is to make sure you receive the MMR vaccine (for measles, mumps and rubella).

Other vaccines may be used for travellers going to meningitis-prone or encephalitis prone countries where arboviruses are more common. Vaccinations are available for Japanese encephalitis, tick-borne encephalitis and encephalitis caused by rabies. Arbovirus risk however can be minimised by limiting exposure to mosquitoes, limiting outdoor activities at night, wearing long sleeved clothing, using insect repellents, and eliminating freestanding water around the home.

Those with close contact with someone who has had meningococcal meningitis may be prescribed antibiotics for a few days to decrease their risk of developing an infection. Close contacts usually means household members, or intimate kissing contacts within the previous week. These people are offered a short course of antibiotics to prevent possible infection although their risk is low.

If group C meningococcus is the cause of the meningitis, then immunisation is also offered to close contacts. If there has been an outbreak of meningococcal infection antibiotics and/or immunisation may then be offered to a wider group of people e.g. students in the same class for example. It should be remembered however that simple measures such as hand washing will dramatically reduce your chances of catching the organisms that may be responsible for meningitis and encephalitis.

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