2 Progressive vaso-occlusive damage to the spleen leads to a state of functional asplenia
together with other immune system dysfunctions.
Persons with persistent complement component deficiencies (including inherited or chronic deficiencies in C3, C5-C9, properdin, factor D, factor H, or who are taking eculizumab [Solaris]); persons with anatomic or functional asplenia
(including sickle cell disease); microbiologists routinely exposed to isolates of Neisseria meningitidis; persons identified as at increased risk because of a serogroup B meningococcal disease outbreak.
Meningococcal vaccination guidelines also underwent several small changes pertaining to adults with anatomical or functional asplenia
and human immunodeficiency virus, among other risk factors.
In individuals with anatomic or functional asplenia
, meningococcal (groups A, C, Y, and W-135) polysaccharide diphtheria toxoid conjugate vaccine (MCV4-D, Menactra) should be given 4 weeks after the last dose of the pneumococcal conjugate vaccine (PCV13).
TABLE 3 Using meningococcal B vaccines in those at high risk and during outbreaks (4) Recommend MenB vaccine for individuals >10 years of age who have any of the following risk factors: * persistent complement component deficiencies * anatomic or functional asplenia
* routine exposure to isolates of Neisseria meningitidis (ie, microbiologists) * exposure to a community experiencing a serogroup B meningococcal disease outbreak.
26, the panel voted 15-0 to recommend vaccination for the following groups of people over age 10 years at increased risk of serogroup B meningococcal disease: those with persistent complement deficiencies; anatomic or functional asplenia
, including people with sickle cell; microbiologists routinely exposed to Neisseria meningitidis isolates; and individuals, such as college students, at increased risk during an outbreak of serogroup B meningococcal disease.
11) Babesiosis, in turn, may cause a functional asplenia
through similar mechanisms.
Revaccination with MCV4 after 5 years is recommended for individuals who continue to be at risk for infection, such as adults with anatomic or functional asplenia
Children with functional asplenia
and immune system impairment are at a risk of developing more fulminant pneumonia due to M.
Adults above age 50 (for annual influenza vaccination) and above age 65 (for one-time pneumococcal vaccination) and above age 50 (for every ten-yearly tetanus-diphtheria toxoid booster) who are either healthy OR have medical conditions such as: heart disease, pulmonary disease, diabetes mellitus, liver disease, renal failure, alcoholism, immune suppression such as HIV and congenital immunodeficiency, anatomic or functional asplenia
(sickle cell disease, splenectomy), malignancies (lymphoma, leukemia, solid tumors), patients receiving immunosuppressants including steroids, bone marrow- and organ-transplant recipients.
In patients with the hemoglobin SS genotype, ASSC is a pediatric disease: functional asplenia
results from recurrent splenic infarctions in childhood, and by adulthood, there is little distensible splenic tissue remaining.
This included those with functional asplenia
, as in sickle cell disease; immunodeficiency, as with HIV disease; diabetes; and chronic cardiac, pulmonary, or renal disease.