Incubation period days

Period of communicability Chronic nasal infection can remain for a prolonged period.

Occurrence and distribution H. influenzae is the commonest cause of meningitis in infants and young children under 5 years of age, mainly 4-18 months of age. At present, it is a serious problem in developing countries, but with the advent of universal Hib vaccination, the incidence is likely to decline considerably, as has been the case in developed countries.

Control and prevention Routine vaccination of all children with Hib vaccine is now recommended. Vaccine should be given at the same time as DTP or as a combination vaccine (DTP/Hib). National vaccination programmes may include a booster dose at 12-18 months, but in most developing countries H. influenzae infection occurs before this age. Where vaccination programmes are starting or catch-up vaccination of adults and children over 18 months is to be done, a single dose of vaccine is sufficient. Hib can safely be given at the same time as meningococcal vaccine.

In the event of an outbreak of several cases of meningitis, vaccination should be given to all children under 5 years of age within the area. Contacts of all ages in households or close communities where there are unvaccinated children should be given prophylaxis with rifampicin (see also Section 13.6).

Treatment is with ampicillin or chloram-phenicol.

Surveillance All family and contacts of a case of meningitis should be investigated by nose swabs. Children under 5 years of age, who have been in contact with a case, should be followed-up and treatment started if they develop early signs, such as fever.

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