title: Selective primary health care: strategies for control of disease in the developing world. XIII. Acute bacterial meningitis.
abstract: Three species of bacteria (Haemophilus influenzae type b, Neisseria meningitidis, and Streptococcus pneumoniae) cause approximately three-quarters of all cases of acute bacterial meningitis in industrialized and developing countries. Infections due to N. meningitidis, S. pneumoniae, and H. influenzae type b are endemic in most countries; major epidemics of meningococcal disease still occur regularly, especially in sub- Saharan Africa. Such epidemics may be large, involving many thousands of patients, with a mortality that can exceed 10%. Both chemoprophylaxis and immunization are used to prevent meningococcal, pneumococcal, and H. influenzae type b meningitis. Chemoprophylaxis may involve the use of expensive antibiotics, and it can encourage the emergence of drug resistance. Mass immunization with meningococcal polysaccharide vaccine can effectively halt an epidemic of group A or group C meningococcal disease, and immunization protects close contacts. However, polysaccharide vaccines are ineffective in infants, who are very susceptible to bacterial meningitis. New protein-polysaccharide conjugated vaccines may be more effective in this young population.
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000349:Africa; D000367:Age Factors; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001428:Bacterial Vaccines; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D004196:Disease Outbreaks / Q000517:prevention & control; D005260:Female; D006193:Haemophilus influenzae / Q000276:immunology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008581:Meningitis / Q000453:epidemiology; D008583:Meningitis, Haemophilus / Q000517:prevention & control*; D008585:Meningitis, Meningococcal / Q000517:prevention & control*; D008586:Meningitis, Pneumococcal / Q000517:prevention & control*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000276:immunology; D010219:Papua New Guinea; D022242:Pneumococcal Vaccines; D011634:Public Health; D014611:Vaccination
chemical_list: D000900:Anti-Bacterial Agents; D001428:Bacterial Vaccines; D022242:Pneumococcal Vaccines