Meningitis

 Meningitis is a rare infection that affects the delicate membranes -- called meninges -- that
cover the brain and spinal cord. You or your children can catch it.
 There are several causes of this disease, including bacteria, viruses, and fungi.
 Bacterial meningitis can be life-threatening and spreads between people in close contact
with each other.
 Viral meningitis tends to be less severe, and most people recover completely without
treatment.

Incubation Period
The incubation period depends on the causative agent. For example, the incubation period
of meningococcal meningitis is 2-10 days while the incubation for hemophilus meningitis is much
shorter ranging from 2-4 days. However, the range of incubation for most organisms causing
meningitis is 2 days to 2 weeks.
Transmission
Neisseria meningitidis only infects humans; there is no animal reservoir. The bacteria are
transmitted from person-to-person through droplets of respiratory or throat secretions from
carriers. Smoking, close and prolonged contact – such as kissing, sneezing or coughing on
someone, or living in close quarters with a carrier – facilitates the spread of the disease.
Transmission of N. meningitidis is facilitated during mass gatherings (recent examples include the
Haj pilgrimage, and jamborees).
The bacteria can be carried in the throat and sometimes overwhelms the body's defences
allowing the bacteria to spread through the bloodstream to the brain. It is believed that 1% to 10%
of the population carries N. meningitidis in their throat at any given time. However, the carriage
rate may be higher (10% to 25%) in epidemic situations.

Common Signs and Symptoms of Meningitis

Bacterial meningitis symptoms may develop within hoursor days. Viral meningitis symptoms may
also develop quickly or over several days.
Fever, severe headache, and neck stiffness are the hallmark symptoms of meningitis. Others
include:
 Nausea and vomiting
 Confusion and disorientation (acting "goofy")
 Drowsiness or sluggishness
 Sensitivity to bright light
 Poor appetite
More severe symptoms include seizure and coma.
In infants, symptoms may include fever, irritability, poor feeding, and lethargy.Additionally, the
soft spot on the top of the head may appear to be bulging.

Prevention

1. Vaccination

Licensed vaccines against meningococcal disease have been available for more than 40 years.
Over time, there have been major improvements in strain coverage and vaccine availability, but
to date no universal vaccine against meningococcal disease exists. Vaccines are serogroup
specific and confer varying degrees of duration of protection.

There are three types of vaccines available:

 Polysaccharide vaccines are used during a response to outbreaks, mainly in Africa:

o They are either bivalent (serogroups A and C), trivalent (A, C and W), or
tetravalent (A, C, Y and W).
o They are not effective before 2 years of age.
o They offer a 3-year protection but do not induce herd immunity.
 Conjugate vaccines are used in prevention (into routine immunization schedules and
preventive campaigns) and outbreak response:
o They confer longer-lasting immunity (5 years and more), prevent carriage and
induce herd immunity.
o They can be used as soon as of one year of age.
o Available vaccines include:
 Monovalent C
 Monovalent A
 Tetravalent (serogroups A, C, Y, W).
 Protein based vaccine, against N. meningitidis B. It has been introduced into the routine
immunization schedule (one country as of 2017) and used in outbreak response.

2. Chemoprophylaxis

Antibiotic prophylaxis for close contacts, when given promptly, decreases the risk of
transmission.

 Outside the African meningitis belt, chemoprophylaxis is recommended for close

contacts within the household.
 In the meningitis belt, chemoprophylaxis for close contacts is recommended in non-
epidemic situations.

Ciprofloxacin antibiotic is the antibiotic of choice, and ceftriaxone an alternative.

Treatment

The treatment depends on the type of meningitis you or your child has.

Bacterial meningitis

Acute bacterial meningitis must be treated immediately with intravenous antibiotics and
sometimes corticosteroids. This helps to ensure recovery and reduce the risk of complications,
such as brain swelling and seizures.

The antibiotic or combination of antibiotics depends on the type of bacteria causing the infection.
Your doctor may recommend a broad-spectrum antibiotic until he or she can determine the exact
cause of the meningitis.

Your doctor may drain any infected sinuses or mastoids — the bones behind the outer ear that
connect to the middle ear.

Viral meningitis

Antibiotics can't cure viral meningitis, and most cases improve on their own in several weeks.
Treatment of mild cases of viral meningitis usually includes:

 Bed rest

 Plenty of fluids

 Over-the-counter pain medications to help reduce fever and relieve body aches

Your doctor may prescribe corticosteroids to reduce swelling in the brain, and an anticonvulsant
medication to control seizures. If a herpes virus caused your meningitis, an antiviral medication
is available.
Expanded Program on Immunization

Rationale

The Expanded Program on Immunization (EPI) was established in 1976 to ensure that
infants/children and mothers have access to routinely recommended infant/childhood vaccines.
Six vaccine-preventable diseases were initially included in the EPI: tuberculosis, poliomyelitis,
diphtheria, tetanus, pertussis and measles. In 1986, 21.3% “fully immunized” children less than
fourteen months of age based on the EPI Comprehensive Program review.

Over-all Goal:

To reduce the morbidity and mortality among children against the most common vaccine-
preventable diseases.
Specific Goals:

1. To immunize all infants/children against the most common vaccine-preventable diseases.

2. To sustain the polio-free status of the Philippines.

3. To eliminate measles infection.

4. To eliminate maternal and neonatal tetanus

5. To control diphtheria, pertussis, hepatitis b and German measles.

6. To prevent extra pulmonary tuberculosis among children.