The UK is currently experiencing an epidemic of pertussis (whooping cough), in spite of the fact that uptake of immunisation against this disease has remained consistently high for some time. The number of cases is far higher in adults and adolescents, but there has also been a huge increase in the burden of disease among infants under 3 months, in whom the outcome is potentially far more serious. Last year, 14 infants died from the disease, prompting the Joint Committee on Vaccination and Immunisation (JCVI) to recommend vaccination for all women in the third trimester of pregnancy. This article looks at the background to the current epidemic, outlining the history of the disease; the underpinning immunological principles that have influenced attempts to control its spread to date; the current immunisation schedule; and other possible measures being considered.

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Meningitis, defined as the inflammation of the lining surrounding the spine and the brain, can be caused by bacteria, viruses and fungi. Bacterial meningitis is the most serious form of the disease, causing around 170000 deaths worldwide each year. Most cases of bacterial meningitis are caused by three bacteria-Streptococcus pneumoniae, Neisseria meningitidis and Haemophilus influenzae type B. In the UK, vaccines are available to combat most of these, yet, according to the Meningitis Research Foundation, around 3400 cases of bacterial meningitis and septicaemia occur every year in the UK and the Republic of Ireland. This article reviews the history of vaccination against meningitis, explores the challenges facing nurses who are at the interface of immunisation policy and public expectations, outlines the current schedule and discusses advances in vaccine technology that offer the potential of a new immunisation against N meningitidis B, the leading cause of meningitis in the UK.