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VaccinationThe use of H influenzae type B (HIB) vaccination is strongly recommended in susceptible individuals (although there is no standard recommendation for H influenzae vaccination in adults). Vaccination against S pneumoniae is also strongly encouraged for susceptible individuals, including people older than 65 years and individuals with chronic cardiopulmonary illnesses. It is not known whether the adult use of conjugate pneumococcal vaccine decreases the incidence of S pneumoniae meningitis. Vaccinations against encapsulated bacterial organisms (eg, S pneumoniae, N meningitidis) are encouraged for people with functional or structural asplenia. Always administer vaccinations expediently to individuals who undergo splenectomy. Offer vaccination with quadrivalent meningococcal polysaccharide vaccine to all high-risk populations, including those with underlying immune deficiencies, those who travel to hyperendemic areas and epidemic areas, and those involved with laboratory work that deals with routine exposure to N meningitidis. College students who live in dormitories or residence halls are at modest risk; inform them about the risk and offer vaccination. One vaccine protects against 4 strains of N meningitidis. The Advisory Committee on Immunization Practices no longer recommends routine immunization of children, but they continue to recommend routine immunization of teenagers and all children/adults at increased risk.[30] In June 2012 the FDA approved MenHibrix, a combination vaccine containing meningococcal serogroups C&Y plus Haemophilus influenza type b. The vaccine is approved in children as young as 6 weeks old and is indicated to prevent meningitis infection caused by N meningitides serogroups C & Y plus Haemophilus influenzae type b. The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) issued updated recommendations in 2010 for use of meningococcal conjugate vaccines. Two new recommendations focus on the routine vaccination of adolescents and on a primary series of vaccinations of persons aged 2-55 years with certain risk factors for meningococcal infection.[31] Regarding the routine use of vaccines in adolescents, the 2010 CDC-ACIP guidelines specifically recommend 1 dose of meningococcal conjugate vaccine, preferably starting at 11 or 12 years. A booster dose should be given at age 16 years. If the primary dose was at age 13-15 years, the booster can be given at age 16-18 years. No booster is needed if the primary dose was on or after age 16 years.[31] The 2010 CDC-ACIP issued specific recommendations for those with certain risk factors for meningococcal infection. HIV-infected individuals aged 11-18 years should be given a primary series of 2 doses, 2 months apart. This should be followed by a booster dose administered at age 16 years if the primary dose was at age 11 or 12, and at age 16-18 years if the primary dose was at age 13-15 years. No booster is needed if the primary dose was on or after age 16 years.[31] Persons aged 2-55 years with persistent complement component deficiency or asplenia (functional or anatomic) should be given a primary series of 2 doses, 2 months apart, followed by a booster dose every 5 years. If a 1-dose primary series was given, the booster dose should be given as soon as possible, then every 5 years thereafter.[31] In persons aged 2-55 years with a protracted increased risk for exposure to meningitis, the 2010 CDC-ACIP guidelines recommend a 1-dose primary series. The booster dose should be given after 3 years for children aged 2-6 years, and after 5 years for persons aged 7 years or older, if the person remains at increased risk.[31] Vaccination against measles and mumps effectively eliminates aseptic meningitis syndrome caused by these pathogens. Дата добавления: 2015-09-18 | Просмотры: 575 | Нарушение авторских прав |