O

Prevention and Treatment 1

A vaccine composed of purified capsular &

polysaccharides from the four major disease- g causing groups is available. The vaccine is §

used to control epidemics caused by these 5

groups and to immunize people at high risk <8

for the disease. It is not given routinely o because it is not very effective in children less than two years old and its effect is not long lasting, but better vaccines are near-ing approval. A number of outbreaks of meningitis due to group B strains have occurred. Group B strains possess a poorly immunogenic polysaccharide, and as yet, no vaccine is available for their control. Mass prophylaxis with an appropriate antibacterial medication, however, can be useful in controlling epidemics in small confined groups as in jails, nursing homes, and schools. Since meningococcal strains from patients with active disease may be more virulent than other strains, people intimately exposed to cases of meningococcal disease are routinely given prophylactic treatment with the antibiotic rifampin. Meningococcal meningitis can usually be cured unless severe brain injury or shock is present. The mortality rate is less than 10% in treated cases. Table 26.1 gives the main features of this disease.

Listeriosis

Meningitis is a common manifestation of listeriosis, a foodborne disease caused by Listeria monocytogenes. Although generally causing only a small percentage of meningitis cases in the United States, epidemics sometimes occur. ■ foodborne illness, p. 811

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