Meningococcal education: more than just a vaccine

Meningococcal ACWY vaccine uptake and awareness among student freshers enrolled at Northern Ireland universities

A new MenACWY conjugate meningococcal vaccination programme was introduced in Northern Ireland (NI) in August 2015, for 13-18 year olds, as well as for first-time university entrants up to 25 years. This reflected the response made by Public Health England, due to the recent rapid increase of meningococcal group W (MenW) disease and on advice of the UK Joint Committee on Vaccination and Immunisation (JCVI). The aims of this study were to evaluate (i) the uptake of the MenACWY vaccine among first-time university students, (ii) vaccine and meningitis awareness, (iii) optimal communication modalities via a multidisciplinary team (MDT) model and (iv) current international vaccination policies relating to non-UK students. A survey was completed by 1210 students, 868 first-time freshers and 342 non-freshers, from healthcare-related, non-healthcare-related and engineering/computing faculties. The survey included an anonymous questionnaire and consented students were aged 17-50 years with a 2:3 ratio of male:female. Vaccine uptake amongst 18-year-old students was 90.7% and 87.3% in female and male cohorts, respectively, falling to 72.1% and 67.7% (19-year cohort) and 32.7% and 39.6% (20- to 25-year cohort) in males and females, respectively. Students reported that posters, clinics and talks were the preferred methods of communication and not social media. There was general lack of awareness of the signs/symptoms of meningitis and approximately 30% of students falsely believed that administration of the MenACWY vaccine excluded the risk of contracting meningitis. Overall, there was a successful vaccination campaign; however, there was a lack of meningitis awareness. Due to differing international meningococcal vaccination schedules, international students enrolling at UK universities need to be informed about current UK policies. For the successful introduction of any vaccination programme amongst university students, it is fundamental that a MDT is established to inform and deliver such a programme in an efficient and timely manner.

Cochlear Preservation After Meningitis: An Animal Model Confirmation of Adjunctive Steroid Therapy

OBJECTIVE/HYPOTHESIS

The objective of the present study was to determine whether treating pneumococcal meningitis with a combined antibiotic and steroid regime will prevent cochlear damage, a common pneumococcal meningitis side effect.

STUDY DESIGN

This was a prospective animal study.

METHODS

Gerbils were randomly assigned to three experimental groups. Animals in group 1, the control animals, received intrathecal saline injections. Animals in groups 2 and 3 received intrathecal injections of Streptococcus pneumoniae to induce meningitis. Although group 2 solely was treated for 7 days with intraperitoneal penicillin injections (48,0000 units), group 3 received, in addition to the antibiotic for 4 days, 0.5 mg/kg intraperitoneal dexamethasone injections. Three months after the meningitis was induced, the animals' cochlear function was determined using auditory brainstem responses (ABRs). Fifteen frequencies were tested, five octaves at three steps per octave between 2 and 50 kHz.

RESULTS

ABR thresholds were significantly elevated only in group 2. When compared with group 1, ABR thresholds were 19 dB higher (P<.05). Frequencies at the low-frequency end of the hearing range were affected more than the midfrequencies. Animals that received dexamethasone had 2-dB higher thresholds than the control group (P>.05).

CONCLUSIONS

Dexamethasone therapy in conjunction with antibiotic therapy preserves cochlear function in cases of S. pneumoniae meningitis in the Mongolian gerbil model.