A comprehensive review of all major agents causing bacterial meningitis–meningococcus of the groups A, B, C, W135, and Y, pneumococcus, and Haemophilus influenzae type B (Hib)–is done in terms of preventing them by chemoprophylaxis or vaccination. Some evidence suggests that the group B meningococcal disease may also be very likely preventable by a vaccine that is already available. Excellent Hib conjugates use a technique that is expected to revolutionize immunoprophylaxis against most meningococcal and pneumococcal diseases in the near future. Unfortunately, the high cost of conjugate vaccines restricts their use in many poor countries.
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