FOLLOWING your article (LET, November 30), may I explain the way in which cases of suspected and confirmed cases of meningococcal infections (meningitis and septicaemia/blood poisoning) are followed up by our Public Health Department?

We work to guidelines drawn up by national experts in the field and published by the Public Health Laboratory Service.

When a case occurs in a school, the chances of another case occurring in the school are very small. Close contacts of the case living and sleeping in the same household are much more at risk of acquiring the infection.

Antibiotics are not normally given to pupils at the school after a single case as there is no evidence that further cases will be prevented by giving antibiotics. The antibiotics can destroy the normal protective germs in the nose and throat and they also have side-effects, so their use is reserved for special circumstances.

Similarly, we follow national recommended policy and do not offer immunisation when there has been just one case of meningococcal infection. In many cases, immunisation will not offer protection, as the majority of cases of meningococcal infection are due to the B strain of the meningococcal bacteria, against which there is still no vaccine. Even when the infection is due to the C strain of the bacteria, national guidance does not recommend the offer of vaccine to school contacts of isolated cases because, overall, the risk of another case occurring is low.

Within the current immunisation programme with the new group C meningococcal vaccine, health authorities are required to immunise 15-17 year-olds first, which started in early November in schools and colleges in East Lancashire and immunisation of babies started this week.

These are the age groups which, overall, are most at risk of group C disease. Currently, there is no spare vaccine in the system nationally to immunise anyone outside these age groups but, as the vaccine becomes more freely available during next year, we may be able to be more flexible in our approach.

D A PEAT, Chief Executive, East Lancashire Health Authority, Kenyon Road, Lomeshaye Estate, Nelson.

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