{"id":995,"date":"2026-03-23T10:48:06","date_gmt":"2026-03-23T07:48:06","guid":{"rendered":"https:\/\/www.profdrelifaksoy.com\/en\/?p=995"},"modified":"2026-03-23T12:24:31","modified_gmt":"2026-03-23T09:24:31","slug":"meningitis-symptoms-types-vaccines-and-meningitis-b","status":"publish","type":"post","link":"https:\/\/www.profdrelifaksoy.com\/en\/meningitis-symptoms-types-vaccines-and-meningitis-b\/","title":{"rendered":"Meningitis: Symptoms, Types, Vaccines, and Meningitis B"},"content":{"rendered":"

Meningitis is an inflammation of the membranes surrounding the brain and spinal cord. Its bacterial forms can turn into a life-threatening condition within hours. The recent increase in cases caused by Neisseria meningitidis<\/em> serogroup B on university campuses in the UK has brought the risk gap among unvaccinated young adults back to the agenda.<\/p>\n

Causative Agents and Types<\/h2>\n

Bacterial meningitis \u2014 requires emergency intervention<\/h3>\n

Three main causative agents stand out, varying according to age and immune status:<\/p>\n

Neisseria meningitidis (A, B, C, W, Y)<\/p>\n

Streptococcus pneumoniae<\/p>\n

Haemophilus influenzae type b<\/p>\n

Listeria monocytogenes (\u226550 years, immunosuppressed)<\/p>\n

Viral Meningitis<\/h3>\n

Generally milder course with spontaneous recovery. Enterovirus is the most common causative agent. Due to clinical overlap with herpetic encephalitis, empirical acyclovir initiation may be required.<\/p>\n

Others<\/h3>\n

Fungal, tuberculosis, aseptic meningitis (drug-induced, autoimmune)<\/p>\n

Clinical Findings<\/h3>\n

The classic meningitis triad (fever, neck stiffness, altered consciousness) is fully met in only 44% of adults. Severe headache alone is sufficient to trigger clinical suspicion.<\/p>\n

High fever<\/p>\n

Neck stiffness (Kernig\/Brudzinski +)<\/p>\n

Altered consciousness<\/p>\n

Severe headache<\/p>\n

Light sensitivity (photophobia)<\/p>\n

Nausea \/ vomiting<\/p>\n

Petechial\/purpuric rash<\/p>\n

Emergency alarm sign<\/h2>\n

A purple\/red rash that does not fade with pressure is a sign of meningococcemia and requires immediate emergency intervention<\/strong>. Parenteral antibiotics should be started without waiting for diagnosis.<\/p>\n

Vaccination Strategies<\/h3>\n
\n\n\n\n\n\n\n\n\n\n\n
Vaccine<\/td>\nTarget Agent<\/td>\nTR Schedule<\/td>\nNote<\/td>\n<\/tr>\n<\/thead>\n
Hib<\/strong><\/td>\nH. influenzae<\/em> type b<\/td>\nroutine<\/td>\n2nd, 4th, 6th, 18th month<\/td>\n<\/tr>\n
PCV13 \/ PCV15<\/strong><\/td>\nS. pneumoniae<\/em><\/td>\nroutine<\/td>\n2nd, 4th, 12th month; with PPSV23 for \u226565 years<\/td>\n<\/tr>\n
BCG<\/strong><\/td>\nM. tuberculosis<\/em><\/td>\nroutine<\/td>\nAt birth \/ 2nd month<\/td>\n<\/tr>\n
MenACWY<\/strong><\/td>\nN. meningitidis<\/em> A,C,W,Y<\/td>\nrisk group<\/td>\nHajj pilgrims, asplenia, abroad travel<\/td>\n<\/tr>\n
MenB (Bexsero)<\/strong><\/td>\nN. meningitidis<\/em> B<\/td>\nprivate \/ paid<\/td>\nNot in routine program; administered upon request<\/td>\n<\/tr>\n
MenB (Trumenba)<\/strong><\/td>\nN. meningitidis<\/em> B<\/td>\nprivate \/ paid<\/td>\nAge 10 and above; 2 or 3 doses<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

Meningitis B Vaccine: History and Turkey<\/h2>\n

Since the serogroup B capsule resembles human tissue, the classic polysaccharide vaccine strategy could not be applied. The solution came with reverse vaccinology and outer membrane vesicle technology. Bexsero<\/strong> (GSK) was licensed in Europe in 2013, and Trumenba<\/strong> (Pfizer) in the USA in 2014.<\/p>\n

The UK became the first country in the world to start routine national implementation by including MenB in the infant vaccination program in 2015. Following this decision, a decline of up to 75% in MenB cases among infants was documented in the UK.<\/p>\n

Situation in Turkey<\/h3>\n

Current Status \u2014 Republic of Turkey Ministry of Health<\/p>\n

The MenB vaccine (Bexsero, Trumenba) is not included in Turkey’s routine national vaccination schedule. It can be administered for a fee at private healthcare facilities upon physician evaluation and parent\/patient request. This situation leads to many children and young adults remaining unprotected against N. meningitidis<\/em> serogroup B.<\/p>\n

Current Situation in the UK: Why Young People?<\/h3>\n

The UK’s 2015 vaccination program covers those born after 2005. Today’s university student population (born 2000\u20132005) consists of a generation that did not catch up with the routine vaccination period. When this demographic gap combines with the transmission opportunity created by crowded dormitory and campus environments, cases increase.<\/p>\n

UK Health Security Agency (UKHSA) reported a significant increase in cases in the 2023\u20132024 academic year compared to previous years; MenACWY and MenB vaccines are recommended for unvaccinated students starting university.<\/p>\n

Transmission Routes<\/h3>\n

Respiratory droplets, <\/strong>close\/prolonged contact, <\/strong>kissing \/ sharing items, <\/strong>crowded indoor environments<\/p>\n

The carriage rate in the general population is 10\u201335%, while it can reach up to 25% in adolescents and young adults; asymptomatic carriers constitute the main source of transmission.<\/p>\n

Post-Exposure Prophylaxis<\/h3>\n

Chemoprophylaxis initiated within the first 24 hours is critical in preventing secondary cases after close contact.<\/p>\n

Antibiotic prophylaxis (in order of preference)<\/p>\n

Ciprofloxacin 500 mg single dose (PO)<\/p>\n

Rifampicin 600 mg \u00d7 2\/day \u00d7 2 days (PO)<\/p>\n

Ceftriaxone 250 mg single dose (IM)<\/p>\n

Ceftriaxone is preferred in pregnancy and in the presence of contraindications. It should be verified whether the antibiotic to be administered to the index case starting treatment provides prophylaxis.<\/p>\n

Active Immunization<\/h3>\n

Post-exposure MenB and MenACWY vaccines are administered by decision of the public health authority to provide long-term protection; they do not replace chemoprophylaxis.<\/p>\n

Clinical Summary<\/h3>\n

Although meningitis is largely preventable with early diagnosis and appropriate treatment, it remains an emergency condition with high mortality and morbidity burden.<\/p>\n

The absence of MenB vaccine in the routine program in Turkey creates a significant immunity gap. The UK experience clearly demonstrates how this gap can turn into an outbreak in unvaccinated young adult cohorts.<\/p>\n

Early diagnosis + prophylaxis + vaccination = saves lives.<\/strong><\/h2>\n

References:<\/strong><\/p>\n

1-van de Beek D, et al. Community-acquired bacterial meningitis in adults. N Engl J Med<\/em>. 2006;354:44\u201353.<\/p>\n

2-Pace D, Pollard AJ. Meningococcal disease: clinical presentation and sequelae. Vaccine<\/em>. 2012;30 Suppl 2:B3\u20139.<\/p>\n

3-Maiden MC, et al. MLST revisited: the gene-by-gene approach to bacterial genomics. Nat Rev Microbiol<\/em>. 2013;11:728\u201336.<\/p>\n

4-Giuliani MM, et al. A universal vaccine for serogroup B meningococcus. Science<\/em>. 2006;312:1060\u20134.<\/p>\n

5-Ladhani SN, et al. MenB vaccination impact, England. N Engl J Med<\/em>. 2020;382:447\u201357.<\/p>\n

6-UK Health Security Agency (UKHSA). Meningococcal disease: guidance, data and analysis. 2024.<\/p>\n

7-Republic of Turkey Ministry of Health. Expanded Immunization Program Circular. 2024.<\/p>\n

8-European Centre for Disease Prevention and Control (ECDC). Meningococcal disease \u2014 annual epidemiological report. 2023.<\/p>\n

Prof. Dr. Elif Aksoy<\/strong>
\nENT Head and Neck Surgery Specialist<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Meningitis is an inflammation of the membranes surrounding the brain and spinal cord. Its bacterial forms can turn into a life-threatening condition within hours. The recent increase in cases caused by Neisseria meningitidis serogroup B on university campuses in the UK has brought the risk gap among unvaccinated young adults back to the agenda. Causative […]<\/p>\n","protected":false},"author":1,"featured_media":996,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-995","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"_links":{"self":[{"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/posts\/995","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/comments?post=995"}],"version-history":[{"count":3,"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/posts\/995\/revisions"}],"predecessor-version":[{"id":999,"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/posts\/995\/revisions\/999"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/media\/996"}],"wp:attachment":[{"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/media?parent=995"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/categories?post=995"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.profdrelifaksoy.com\/en\/wp-json\/wp\/v2\/tags?post=995"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}