In the U.S., we’ve done a great job of preventing meningitis. Three of the most important bacteria that cause the disease now have effective vaccines. Haemophilus influenzae type b (Hib) was a very common cause of childhood diseases, including ear infections. It was a common cause of epiglottitis, a disease that could quickly suffocate a young child. It also causes meningitis. As a medical student, we were instilled with a healthy respect for the disease. We learned the signs of epiglottitis, its appearance on X-ray. But we didn’t see that many cases. Since the introduction of the vaccine in the late 1980s, the incidence of severe disease due to Hib has dropped 99%. Streptococcus pneumoniae (pneumococcus; sorry, no better nickname available) is a common cause of pneumonia, and like Hib, it can cause ear infections in children. It can also cause meningitis. Before the wide use of the vaccine, about 200 kids died every year of pneumococcus infections, including meningitis. Routine vaccination has led to a 99% decrease in severe pneumococcal disease in children. The “classic” type of meningitis is caused by Neisseria meningitidis (meningococcus; also no good nickname). This is a bacteria that lives harmlessly in many people, but under the right conditions can migrate into the lining of the brain causing a devastating disease. Our success with vaccination against this disease has been a bit more complex than with the other two. There are many different types of this bacterium, identified by a capital letter. The most common in the US are B, Y, C, W-135. Vaccination against Y, C, and W is has been very effective. In the US, type B is rare after infancy, and no vaccine is available. This is the type that killed Emily.
Posted on: Fri, 27 Jun 2014 04:46:12 +0000
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