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Meningococcal Vaccines



Meningococcal disease is a rare but serious infection caused by the bacterium Neisseria meningitidis.

There are 13 serogroups; those that most commonly cause disease are A, B, C, W and Y.

The incidence of invasive meningococcal disease (IMD) fluctuates naturally over time. The national notification rate declined from 2002 to 2013, but has increased since 2014. Serogroup B disease has been dominant until recently, but has been naturally declining even in the absence of widespread vaccination against this serogroup. There has been a recent increase in serogroup W disease since 2013; this is now the main serogroup causing meningococcal disease (44.5% of cases with identified serogroup) in Australia in 2016.

Septicaemia and/or meningitis are the most common clinical manifestations of IMD. The highest incidence of meningococcal disease is in children aged <5 years and adolescents aged 15–19 years. Carriage rates of the bacteria are highestin older adolescents and young adults.

Serogroup B disease remains the most common cause of IMD in children, adolescents and young adults. Serogroup W disease occurs over a more diverse age range and may present with less typical clinical manifestations than disease due to other serogroups.

Serogroup C has become rare (1.2% of cases with identified serogroup in 2016) since the introduction of the conjugate meningococcal C vaccine to the National Immunisation Program (NIP) in 2003.

Vaccines

Three types of meningococcal vaccines are available in Australia:
  • meningococcal C conjugate vaccine (MenCCV), available as a single vaccine, NeisVac-C®, or in a combination formulation with the Haemophilus influenzae type b (Hib) vaccine (Hib– MenCCV): Menitorix®
  • multicomponent meningococcal B vaccine (MenBV): Bexsero®
  • quadrivalent (A, C, W, Y) meningococcal conjugate vaccines (4vMenCV): Menactra®, Menveo®, Nimenrix®. (These have replaced quadrivalent polysaccharide vaccines which are now discontinued.)

Who should be vaccinated
  • People at increased risk of IMD: Those with complement disorders, asplenia and other immunocompromising conditions, or occupational exposure should be vaccinated with MenBV and 4vMenCV.
  • People within age groups with increased incidence of IMD or high carriage rates of N. meningitidis:

    • Infants and young children particularly those aged =2 years of age: Routine MenCCV at 12 months of age is recommended and funded under the NIP. MenBV is also recommended and 4vMenCV may be offered to protect against A, C, W and Y serogroups. MenBV and 4vMenCV are available through private prescription for this age group, but are not funded.
    • Adolescents and young adults (15–19 years): MenBV is recommended and 4vMenCV may be offered, particularly for those living in close quarters such as new military recruits and students living in residential accommodation. In some Australian states, these vaccines are funded for this age group in response to locally predominant meningococcal B or W disease.
    • Travellers: 4vMenCV is recommended for travellers to certain destinations where there is an increased risk of exposure (including, but not limited to, the ‘meningitis belt’ of sub-Saharan Africa). 4vMenCV is required for pilgrims attending the annual Hajj in Mecca.
    • Anyone wishing to reduce their risk of IMD: Vaccination with MenBV (from 6 weeks of age) and 4vMenCV (from 2 months of age) may be offered and is available through private prescription.

Table 1: Current access to meningococcal vaccines in Australia


VaccineSerogroup(s) coveredAvailability as of March 2017
Combination Haemophilus influenzae type b (Hib) / Meningococcal C conjugate vaccine (Hib–MenCCV)
C
Recommended and funded under the NIP for 1 dose at 12 months of age in all children nationally
Multicomponent meningococcal B vaccine (MenBV)
B
Available through private prescription, from age 6 weeks.
Doses required vary by age.*
Funded in South Australia from April 2017 for a 2 year study for students enrolled in years 10, 11 and 12 in 2017.†‡
Quadrivalent meningococcal conjugate vaccines (4vMenCV)
A, C, W, Y
Available through private prescription. Three vaccine brands for use in different age groups (Table 2).

Funded in New South Wales in 2017 from school term 2 for year 11 and 12 students.‡

Funded in Victoria and Queensland in 2017 for adolescents/young adults aged 15–19 years. Funded in Western Australia (2017–2019) commencing with year 10– 12 students and those aged 18–19 years in 2017, and only year 10 students in 2018–2019. ‡


* Refer to The Australian Immunisation Handbook, 10th edition, 2015 update, for dosing guidelines.
† Funded doses of MenBV for this age group in South Australia are provided through a population-level study assessing the impact of the vaccine on nasopharyngeal carriage of N. meningitidis and herd immunity.
‡ Consult the respective state or territory health department website for further details.


Source: www.ncirs.edu.au meningococcal vaccines fact sheet

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Travelling and Diabetes

Whether for work or pleasure, travel can and should be fun and having diabetes doesn’t mean you can’t travel. With good planning, your trip can be safe, fun and hassle-free whether you’re going interstate or overseas.

While traveling:

  • Make sure you eat well, consider how different foods will affect you
  • Make sure you check your blood glucose levels regularly
  • For people with type 1 diabetes- carry the right lollies with you (overseas brands may not be as strong)
  • If you are flying, prepare for long delays or misplaced baggage (just in case!)
  • If traveling overseas, time zones and extreme climates may affect you and how you manage your diabetes, talk to your doctor or diabetes educator

Planning your travel itinerary & bookings
  • Plan travel itinerary and make bookings.
  • If you wear an electronic device to monitor blood glucose levels or infuse insulin, check with the airline to see if these devices can be operated in-flight.
  • Arrange travel insurance for health and belongings.
  • Check vaccination requirements.

Check Airline Security Regulations

Be sure to make arrangements in advance so that you comply with Australian airline security regulations specifically for people with diabetes. The regulations are:
  • You must carry all diabetes supplies including testing equipment, insulin and Glucagon delivery devices (syringes and pen needles and insulin pump consumables) in the hand luggage of the person who has diabetes and whose name appears on the airline ticket. It is advisable to pack extra insulin in checked-in luggage.
  • Your name must appear on all insulin and/or Glucagon script labels.
  • You must carry scripts for all medications and check them before you go to make sure they are readable. Each script must include your name, the name and type of your medication and your doctor’s contact details.
  • You must carry your National Diabetes Services Scheme (NDSS) card, as it is accepted as primary proof that a person with insulin treated diabetes needs to carry with them their diabetes equipment. Supplementary photographic proof of identify, such as a driver’s licence or passport may also be required.
  • You must carry several copies of a letter from your doctor which you will need to get through Customs. The letter should outline any medical conditions, any medications you take and the devices you use for your insulin and blood glucose testing, such as insulin pens, syringes and needles or pump unit. It should also stress the importance of carrying your medications with you. Check beforehand the letter is readable!
  • International travellers can carry no more that 100 ml of liquid per container, including aerosols and gels, in their carry-on baggage. All liquids must fit into a transparent resealable plastic bag no bigger than one litre (approx. 20 cm by 20 cm). People with diabetes who need to carry supplies of insulin are exempt; however, they will be required to present the insulin at the security point and carry proof of their condition and need for insulin.
    If you are not travelling with an Australian carrier, be sure to check in advance with your chosen airline for specific security guidelines.


Arrange Travel Insurance

You should arrange travel insurance, both for you and your belongings. Make sure your accident and health cover applies to pre-existing conditions and the places you will visit.
The Australian Government has arrangements with a number of countries providing travellers with benefits similar to Medicare, but these are typically only for acute or emergency care.

Talk With Your Doctor
  • Make appointment to have vaccinations (if required).
  • Make appointment with your doctor or credentialled diabetes educator to discuss travel plans, time zones, and other ‘travel’ tablets required.
  • List and buy any special clothing items required, for example comfortable, well fitting shoes.


More information from diabetesaustralia.com.au

The information in the above were collected from the internet,
either from government websites or from reasonably reliable health information sources.
They are for general information only and should not replace the need of seeking medical care during illnesses.

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