Haemophilus influenzae type b (Hib) is a major cause of meningitis and pneumonia in children. In Papua New Guinea (PNG) more than 20% of Hib are now resistant to chloramphenicol, and resistant Hib meningitis treated with chloramphenicol results in certain death or severe brain injury. Third-generation cephalosporins are a therapeutic option but are very expensive, while the Haemophilus influenzae type b conjugate vaccine would provide effective prevention. In a province of 380,000 people, using ceftriaxone as standard treatment for meningitis in all health facilities would only save an estimated 8 more lives per year than using chloramphenicol, and cost US dollars 1514 per additional life saved. Introduction of Hib vaccine would save, each year, 61 more lives than using chloramphenicol and 53 more lives than using ceftriaxone for meningitis treatment. The cost of a vaccination strategy for Hib meningitis would be US dollars 1216 for each of the 61 additional lives saved. Hib vaccine would be by far the most effective intervention to reduce mortality and severe neurological disability from Hib meningitis in PNG. Nationwide introduction of Hib vaccine is urgently needed, as antibiotics are now less effective in this disease than ever before.
Haemophilus influenzae type b bacteria ; Meningitis ; Vaccines ; Chloramphenicol ; Prevention

Epidemic cerebrospinal meningitis (meningococcal meningitis) is an acute respiratory infectious disease with high mortality and serious sequelae. Meningococcal vaccine is an effective measure to prevent and control meningococcal meningitis. At present, group B meningococcal meningitis has become the main prevalent serum group in the world, including China. Meningococcal ACYW and other vaccines are mainly composed of capsular polysaccharides, while the main component of group B meningococcal vaccine is protein, including outer membrane vesicles (OMV) and recombinant protein vaccine. The methods for evaluating the immunogenicity of group B meningococcal vaccine include hSBA and alternative methods such as meningococcal antigen typing system (MATS), flow cytometric meningococcal antigen surface expression assay (MEASURE), genetic meningococcal antigen typing system (gMATS) and bexsero antigen sequence type (BAST). The evaluation of vaccine immunogenicity is the basis of vaccine development and clinical trial research, However, at present, there is no group B meningococcal vaccine in China. Therefore, in this paper, the research progress of immunogenicity evaluation of group B meningococcal vaccine has been reviewed, in order to provide technical guidance for the research and development of group B meningococcal vaccine, immunogenicity evaluation and clinical trial research in China.
Humans ; Meningitis, Meningococcal/prevention & control* ; Meningococcal Vaccines ; Neisseria meningitidis ; Serogroup ; Vaccines, Combined

Meningitis is a life-threatening disease. In order to reduce its threat to public health, the World Health Assembly indorsed a resolution in 2020 for urgent global action to prevent and control meningitis. Defeating Meningitis by 2030: a Global Roadmap was officially launched by the World Health Organization in 2021. We interpreted some key information of the roadmap from the aspects of coverage, objectives and pillar strategies, providing ideas for further strengthening the prevention and control of bacterial meningitis in China.
China/epidemiology* ; Global Health ; Humans ; Meningitis, Bacterial/prevention & control* ; World Health Organization

OBJECTIVETo explore the common complications related to acoustic neuromas and to search methods for preventing from them.

METHODSOne hundred and five patients with acoustic neuromas underwent 110 operations with the retrosigmoid approach, middle cranial fossa approach and labyrinth approach. All cases were followed up more than 1 month after surgery.

RESULTSOf 110 cases, the most frequent complication was hearing disability which occurred in 95 cases (95/110, 86.4%). and the facial paralysis was in 63.6% (70/110) after one month. Other complications were cerebrospinal fluid fistulas (CSF, 12.7%, 14/110) , intracranial hematoma (5.5%, 6/110), cranial nerve palsies (4.5%, 5/110), meningitis (3.6%, 4/110), tetraparesis (3.6%, 4/110), balance disturbance (1.8%, 2/110), hemiparalysis and anepia (0.9%, 1/110). Effective stopping bleeding during operation and controlling blood pressure after operation, as well as keeping effective sedation in 24 hours after operation were the important ways to prevent from intracranial hematoma The haemorrhage often accrued in 48 hours post-operation. CSF in this series was another common complication in acoustic neuroma surgery. Ten cases with CSF subcutaneous retro-auricular had been successfully controlled by conservative treatment. Of 4 cases with rhinorrhea CSF, 3 of them were required surgical management, another one got self-cure by bed rest. The ventricular drainage pro-operation was the most important procedure for drawdown the hypsi-cranium pressure.

CONCLUSIONSThe key factors to avoid the complications include mastering the anatomy of different surgical approach, how much of the tumor size, surgical experience and preoperative evaluation of patients' imaging information and other clinical data.

Adolescent ; Adult ; Aged ; Cerebrospinal Fluid Otorrhea ; etiology ; prevention & control ; Cerebrospinal Fluid Rhinorrhea ; etiology ; prevention & control ; Facial Paralysis ; etiology ; prevention & control ; Female ; Humans ; Male ; Meningitis ; etiology ; prevention & control ; Middle Aged ; Neuroma, Acoustic ; surgery ; Postoperative Complications ; etiology ; prevention & control ; Young Adult

Meningococcal meningitis is an acute, severe respiratory infectious disease caused by Neisseria meningitidis. Immunization with meningococcal vaccine is the most effective measure to control and prevent transmission of meningococcal meningitis. Meningococcal vaccines in the Chinese market include meningococcal polysaccharide vaccine, meningococcal polysaccharide conjugate vaccine, and a combined vaccine containing meningococcal polysaccharide conjugate vaccine. This article reviews research progress on the efficacy, safety, and cost-effectiveness of meningococcal vaccines, particularly in the Chinese market, to support appropriate use of the various meningococcal vaccines for preventing meningococcal meningitis.
Cost-Benefit Analysis ; Humans ; Immunization/economics* ; Meningitis, Meningococcal/prevention & control* ; Meningococcal Vaccines/immunology* ; Vaccination/economics* ; Vaccines, Conjugate/immunology*

The authors present a case of incomplete spinal cord injury (Brown Sequard syndrome) after a stab wound. A direct history and examination revealed that the patient was stabbed in the back while fighting with his friends. He immediately lost motor and sensory function in the lower extremities and collapsed to the ground. The patient was given primary closure after wound toilet and was treated with antibiotics. With rehabilitation he became ambulatory with a cane and long leg brace two months after the stabbing.
Adult ; Antibiotics, Combined/therapeutic use ; Bacterial Infections/prevention&control ; Case Report ; Human ; Male ; Meningitis/prevention & control ; Spinal Cord Injuries/*etiology/radiography/rehabilitation ; *Wounds, Stab

OBJECTIVE: To discuss the perioperative complications of 1396 cases (1402 ears) with cochlear implantation (CI), and to supply clinical experience for risk reduction in the perioperative period. METHOD: All patients were profound sensorineural deafness, with 1379 prelingual cases and 17 postlingual cases. (1) Preoperative examinations: audiology,imaging studies, evaluation of physical and intellectual development. (2) Perioperative complications. RESULT: (1) Perioperative complications: transitory postoperative facial palsy in 4 cases; external auditory canal and membrana tympani injury in 14 cases; gusher in 91 cases; cerebral dura mater injury in 2 cases; problems of electrodes in 31 cases including 2 of electrodes inserted into inner auditory canal and 1 into scala vestibuli, 28 of electrodes squire in the cochlea; transient vertigo in 231 cases; scalp hematoma in 39 cases. (2) Systematic postoperative complications: fever ( >38 degrees C) in 21 cases; acute gastritis in 27 cases; bronchitis and pneumonia in 5 cases; laryngotracheitis in 9 cases. (3) Other complications: artificial cochlear exchange due to computer trouble during operation. CONCLUSION (1) CI is a relatively safe surgical procedure, but risks still persist during perioperative period including postoperative meningitis, facial nerve and chorda tympani nerve injury,and so on. (2) To ensure successful operation, perioperative managements should be standardized.
Adolescent ; Adult ; Child ; Child, Preschool ; Cochlear Implantation ; adverse effects ; methods ; Facial Paralysis ; etiology ; prevention & control ; Humans ; Infant ; Meningitis ; etiology ; prevention & control ; Middle Aged ; Perioperative Period ; Postoperative Complications ; prevention & control ; Young Adult

PURPOSE: This study was performed to investigate the epidemiology of enterovirus (EV) infections in children at a secondary hospital during recent 5 years. METHODS: We collected the cerebrospinal fluid, stool and throat swab samples from the pediatric patients with suspected EV infections in KEPCO Medical Center, Seoul, Korea from July 2006 to September 2010. EV detection and genotype identification were performed by RT-PCR at Korea Centers for Disease Control and Prevention. RESULTS: A total of 386 samples were collected from 277 patients during study period. Ninety-eight patients (35.4%) were diagnosed with EV infections. The RT-PCR positive rate was the highest in throat swab samples (48.3%). The median age of patient was 4.7 years (range, 0.1-12.5 years). Aseptic meningitis (50, 51.0%) was the most common clinical manifestation; herpangina (22, 22.4%) and hand-foot-mouth disease (18, 18.4%). One hundred EVs were isolated from 98 patients and 20 genotypes of EV were identified; Echovirus 30 (28 cases, 28%), Enterovirus 71 (12 cases, 12%), Echovirus 25 (10 cases, 10%), Echovirus 9 (9 cases, 9%) and Coxsackievirus A6 (8 cases, 8%). Aseptic meningitis caused by Echovirus 30 was the most common manifestation in 2008. There was no complicated case caused by Enterovirus 71. CONCLUSION: This study showed the epidemiology of confirmed EV infection in children from 2006 to 2010. There is a need for continuous surveillance of EV infections and its clinical manifestations.
Centers for Disease Control and Prevention (U.S.) ; Child ; Echovirus 9 ; Enterovirus ; Enterovirus B, Human ; Enterovirus Infections ; Genotype ; Herpangina ; Humans ; Korea ; Meningitis, Aseptic ; Pharynx

OBJECTIVETo estimate disease burden and epidemiological characteristics of acute meningitis/encephalitis, and provide the basis for the disease control strategy development.

METHODSA syndrome surveillance system was established in Guigang city with a population of 5 020 000. For the suspected cases, serum and CSF were collected, and bacterial culture, latex agglutination test, real-time PCR and ELISA tests were carried out. All involved cases were identified to 6 categories according to WHO case definition.

RESULTS1424 suspected cases were evaluated in a surveillance of 30 months, yielding the incidence, mortality and mortality of 11.35/100 000 (1424/12 546 500 person years), 0.43/100 000 (54/12 546 500 person years), 3.79% (54/1424) respectively. A total of 103 and 51 cases were confirmed for JE, bacterial meningitis, with a incidence of 0.82/100 000 (103/12 546 500 person years), 0.41/100 000 (51/12 546 500 person years). 96.10% (99/103) of JE cases and 37.30% (19/51) bacterial meningitis cases occurred in < 10 years old children and < 5 years old children. A clinical misdiagnosis rate of 19.42% (20/103) and 15.69% (8/51) were observed for JE and bacterial meningitis.

CONCLUSIONAcute encephalitis, meningitis syndrome can cause a higher burden of disease, of which the main components of viral encephalitis. Most of syndrome is occurred in summer and autumn, mainly reported in children of younger than 10 years old. A quite misdiagnosis would be made among meningitis and encephalitis syndrome cases.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; epidemiology ; Encephalitis, Viral ; epidemiology ; Female ; Humans ; Infant ; Male ; Meningitis, Bacterial ; epidemiology ; Meningoencephalitis ; epidemiology ; microbiology ; prevention & control ; virology ; Middle Aged ; Seasons ; Young Adult

OBJECTIVETo evaluate the safety of meningococcal group AC bivalent polysaccharide conjugate vaccine among children aged 5-24 months old.

METHODSFrom July 2011 to June 2012, a total of 34 411 children aged 5-24 month-old who voluntarily vaccinated meningococcal group AC bivalent polysaccharide conjugate vaccine in Zhongshan city were included. The adverse effects within 72 hours were recorded and analyzed.

RESULTS34 411 children were recruited, including 18 708 boys (54.36%), whose mean age were ( 11.4 ± 3.9 ) months old.Within 72 hours, the incidence rates of local adverse effects were 0.76% (261/34 411) for erythema,0.57% (197/34 411) for sclerosis,0.56% (191/34 411) for swelling,0.42% (143/34 411) for pain,0.15% (53/34 411) for pruritus, and 0.15% (50/34 411) for rash on the injection site. The overall incidence rate of local adverse effects was 1.61% (554/34 411; 95%CI:1.48%-1.74%). The incidence rates of systemic adverse effects were 0.98% (312/34 411) for fever,0.48% (164/34 411) for anorexia,0.31% (108/34 411) for diarrhea,0.29% (100/34 411) for malaise,0.20% (70/34 411) for nausea and vomiting, and 0.08% (26/34 411) for headache. The overall incidence rate of systemic adverse effects was 1.64% (565/34 411; 95%CI:1.51%-1.78%).25 children (0.07%) had hyperpyrexia ( > 39°C), and the time of duration lasted less than 48 hours.16 children (0.05%) had symptoms of cold, such as cough and catarrh.No accident and other serious events were reported. The incidence rate of systemic adverse effects among boys was 1.79% (334/18 708), which was higher than that of girls (1.47%, 231/15 703), the difference showed statistical significance (χ(2) = 5.22, P < 0.01). The incidence rate of systemic adverse effects among children aged 5-12 month-old was 1.78% (411/23 113), which was higher than that among children aged 13-24 month-old (1.36%, 154/11 298), the difference showed statistical significance (χ(2) = 8.10, P < 0.01). The incidence rate of local adverse effects in children vaccinated the first dose was 1.72% (536/31 129), which was higher than that in children vaccinated the second or third dose (0.55%, 18/3282), the difference showed statistical significance (χ(2) = 25.81, P < 0.01). The incidence rate of systemic adverse effects in children vaccinated the first dose was 1.73% (539/31 129), which was higher than that in children vaccinated the second or third dose (0.79%, 26/5282), whose difference also showed statistical significance (χ(2) = 16.22, P < 0.01).

CONCLUSIONThe safety of meningococcal group AC bivalent polysaccharide conjugate vaccine among children aged 5-24 months old is relative good.

Female ; Humans ; Infant ; Male ; Meningitis, Meningococcal ; microbiology ; prevention & control ; Meningococcal Vaccines ; administration & dosage ; adverse effects ; immunology ; Neisseria meningitidis, Serogroup A ; Neisseria meningitidis, Serogroup C ; Polysaccharides, Bacterial ; immunology ; Vaccines, Conjugate ; administration & dosage ; adverse effects ; immunology