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Meningitis: Vaccines
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Many vaccines, such as those for measles, polio, and meningitis, must be kept frozen or within a constant temperature range or they will lose their effectiveness. This situation calls for what is commonly known as a "cold chain." A cold chain is a continuous system of conservation and distribution of vaccines, at a precise temperature, from the factory to the field. MSF has developed a vaccination kit that has enough supplies for five teams to immunize 10,000 people. Included in this kit are ice packs, coolers, generators, gas-powered refrigerators, freezers, and thermometers to maintain the cold chain.
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Bacterial meningitis, formerly called spinal meningitis, is a very serious and potentially fatal infection. It can strike very healthy people, but infants and older people are more susceptible. The three most common types of bacterial meningitis are caused by Neisseria meningitidis, Haemophilus influenza and Streptococcus pneumoniae. The good news is that there are very effective vaccines to help prevent all three types.
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Acute bacterial meningitis: The widespread use of HIB vaccine has dramatically changed the epidemiology of bacterial meningitis during the past decade (see Table 1). Once the most common cause of bacterial meningitis in all age groups, the incidence of H influenzae meningitis has dramatically decreased from 48% to 7% of all cases. The rate of N meningitidis has remained constant at 14-25%, and this organism accounts for many cases among 2- to 18-year-old patients. S pneumoniae has become the most common cause in all age groups (see Table 2).
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In recent years, researchers have made a number of advances against meningitis, ranging from the introduction of vaccines that target the pathogens that cause meningitis to a deeper understanding of how inflammation is crucial to the disease course. During meningitis, the immune system is activated to produce a host of pro-inflammatory chemicals, including tumor necrosis factor-alpha (TNF-alpha) and various interleukins (Pathan N et al 2003). This immune-modulated inflammation causes much of the damage associated with meningitis. In the future, anti-inflammatories are expected to play a major role in conventional meningitis therapy (Pathan N et al 2003).
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Public health officials recommend that all college students take the meningococcal meningitis immunization. In particular, those who live in close quarters (dormitories, fraternities, and sororities), who frequent bars or consume alcohol, who smoke or are regularly around smokers are at higher risk and should consider vaccination. Students with certain chronic conditions (eg, have had their spleen removed) should be vaccinated. Students traveling to high-risk areas of the world (eg, sub-Sahara Africa) should consider vaccination.
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