Preventing severe infection after splenectomy: Risk of malaria and meningitis increases with asplenia

doi:10.1136/bmj.331.7516.576-b

BMJ 2005;331:576 (10 September), doi:10.1136/bmj.331.7516.576-b

Letter

Preventing severe infection after splenectomy

Risk of malaria and meningitis increases with asplenia

The first 150 words of the full text of this article appear below.

EDITOR—The editorial by Newland et al on preventing severeinfection after splenectomy deals with the risks of malarialinfection and meningitis in asplenic travellers rather cursorily.¹

Asplenia, from whatever cause, is not uncommon. Worldwide travelto malarial areas is probably increasing. Increased risks ofPlasmodium falciparum malaria in asplenic people, although difficultto quantify, are widely recognised. Fatal outcomes, anecdotally,are increased: I have heard of three people who acquired malariain west Africa and died. Incidence of meningitis in sub-SaharanAfrica, India, and Nepal poses substantial potential hazards.

Asplenic travellers should be advised to avoid travel to highrisk malarial areas. People who travel should scrupulously adhereto measures to avoid bites and take appropriate antimalarialprophylaxis. Immediate referral for medical advice is essentialshould a fever develop. People travelling to areas with a highincidence of meningitis must be immunised with meningococcalACWY vaccine (quadrivalent polysaccharide . . . [Full text of this article]

Harald M Lipman, medical adviser, travel health clinic

Number One Health Group, London W1G 9QD haraldlipman@aol.com