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Children are exposed to a greater risk than adults for severe late postsplenectomy infection. Therefore, prophylaxis against bacterial infections need to be more extensive. This paper presents a protocol for preventive measures in children. Repeated education of the patient and his/her parents about the consequences of splenic loss is mandatory. Vaccinations against Streptococcus pneumoniae and Hemophilus influenzae are highly recommended and also against Neisseria meningitidis in certain situations. The importance of long-term antibiotic prophylaxis in children is emphasized. Recent advances in vaccine development and the increasing problems with antibiotic resistance are discussed.

The prevention of severe late postsplenectomy infection by vaccination and antibiotic prophylaxis is controversial. This paper reviews the literature and presents a protocol for postsplenectomy adults. Prophylaxis should be adapted to the underlying disease. Every patient has to be informed about the consequences of splenectomy. Depending on the underlying disease, vaccination is recommended against pneumococci, Hemophilus influenzae and Neisseria meningitidis. Long-term antibiotic prophylaxis is not advised in adults.

Summarizes the results of the epidemiologic investigation conducted by the Alaska Department of Health and Social Services (ADHSS) and underscores the importance of second-dose requirements for measles vaccine. Reported measles cases from August 10 through November 23, 1998; Emergency order issued by ADHSS; Details on the school program implemented in the country.