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Meningococcal disease
Meningococcal vaccine is recommended for adults and children >2 years old who are traveling to areas where epidemics are occurring, or to the "meningitis belt" (semi-arid areas of subSaharan Africa extending from Senegal and Guinea eastward to Ethiopia) from December to June . Saudi Arabia requires a certificate of immunization for pilgrims during the Hajj. Immunization should also be considered for travellers who will be living in a dormitory or refugee camp, or working in a health care setting
A quadrivalent single-dose meningococcal polysaccharide vaccine (Menomune - Aventis Pasteur) is available against Neisseria meningitides serogroups A, C, Y, and W135. The duration of immunity is at least 3 years; it may be shorter in children <4 years old. Conjugate vaccines against serogroups A and C available outside the US may be more effective in children <2 years old.
Pathophysiolog y Normally the platelets are formed from megakaryocytes (stem cells) in the. bone marrow. These cells mature, fragment and are released in the blood strea
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define fringing reef
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