{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:37:34Z","timestamp":1747186654909,"version":"3.40.5"},"reference-count":16,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T00:00:00Z","timestamp":1543363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To document the clinical features and management of infants presenting with fever after their first meningococcal B vaccination and develop guidance for clinicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A prospective case series over 12\u2009months was conducted in a tertiary paediatric hospital. Infants \u22643\u2009months of age with fever who had received their first set of immunisations within the preceding 72\u2009h were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 92 infants met the inclusion criteria, accounting for 0.78% of the local vaccinated population. The most commonly described associated features were poor feeding, sleepiness and irritability; 66 patients (72%) were admitted to hospital. Median C\u2010reactive protein (CRP) was 12\u2009mg\/L, and median white cell count (WCC) was 16\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L. Fifteen patients (16%) had a lumbar puncture and were commenced on antibiotics. There was one confirmed bacterial infection in an infant who had presented with fever starting 54\u2009h after immunisation. All other microbiology samples were negative. There were no cases of missed serious bacterial infection (SBI) in those patients who were observed or discharged.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The routine investigation of infants presenting with post\u2010immunisation fever is not warranted if the infant appears otherwise well on examination. Where other common associated features are present or there is clinical concern, a period of observation is a prudent course of action. Paracetamol should be given peri\u2010immunisation as per the national guidance. We suggest selective use of investigations, especially inflammatory markers, which are unlikely to discriminate between SBI and post\u2010immunisation response. We advocate extra caution in infants presenting with fever more than 48\u2009h after immunisation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14315","type":"journal-article","created":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T04:00:40Z","timestamp":1543464040000},"page":"932-937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Fever after meningococcal B immunisation: A case series"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9112-7503","authenticated-orcid":false,"given":"Gillian","family":"Campbell","sequence":"first","affiliation":[{"name":"Emergency Department, Royal Hospital for Children  Glasgow United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth M","family":"Bland","sequence":"additional","affiliation":[{"name":"Emergency Department, Royal Hospital for Children  Glasgow United Kingdom"},{"name":"Insitute of Health and Wellbeing, University of Glasgow  Glasgow United Kingdom"},{"name":"School of Public Health, University of Witwatersrand  Johannesburg, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott J","family":"Hendry","sequence":"additional","affiliation":[{"name":"Emergency Department, Royal Hospital for Children  Glasgow United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"National Institute for Health and Clinical Excellence.Management of Bacterial Meningitis and Meningococcal Septicaemia in Children and Young People Younger than 16 Years in Primary and Secondary Care. London: The Institute; 2010. Clinical Guideline No.: 102. Available from:https:\/\/www.nice.org.uk\/guidance\/CG102[accessed 19 July 2017]."},{"key":"e_1_2_6_3_1","unstructured":"Public Health England.Immunisation Against Infectious Disease: The Green Book. London: Public Health England; 2013. Available from:https:\/\/www.gov.uk\/government\/publications\/immunisation\u2010against\u2010infectious\u2010disease\u2010the\u2010green\u2010book\u2010front\u2010cover\u2010and\u2010contents\u2010page[accessed 19 July 2017]."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.85"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61961-8"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.4161\/hv.28666"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.4161\/hv.29218"},{"key":"e_1_2_6_8_1","unstructured":"National Health Services Scotland.What to Expect After Immunisation \u2010 Babies and Children up to 5 Years. Edinburgh: National Health Services; 2017. Available from:http:\/\/www.healthscotland.com\/uploads\/documents\/6122\u2010What%20to%20expect%20after%20immunisation%20Babies%20&%20Young%20children\u2010Dec2016\u2010English.pdf[accessed 19 July 2017]."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-310863.220"},{"key":"e_1_2_6_10_1","unstructured":"National Institute for Clinical Excellence guideline.Fever in Under 5s: Assessment and Initial Management. London: The Institute; 2013. NICE Guidelines No.: CG160. Available from:https:\/\/www.nice.org.uk\/guidance\/cg160[accessed 19 July 2017]."},{"key":"e_1_2_6_11_1","first-page":"289","article-title":"Pathophysiology of reactions associated with pertussis vaccine","volume":"73","author":"Blumberg DA","year":"1991","journal-title":"Dev. Biol. Stand."},{"key":"e_1_2_6_12_1","article-title":"The Yale observation scale score and the risk of serious bacterial infections in febrile infants","volume":"142","author":"Nigrovic LE","year":"2018","journal-title":"Paediatrics"},{"key":"e_1_2_6_13_1","unstructured":"National Health Services Scotland.Childhood Immunisation Statistics Scotland \u2014 Quarter and Year Ending 31 March 2017. Edinburgh: National Health Services; 2017. Available from:https:\/\/www.isdscotland.org\/Health\u2010Topics\/Child\u2010Health\/Publications\/2017\u201006\u201027\/2017\u201006\u201027\u2010Immunisation\u2010Summary.pdf[accessed 19 July 2017]."},{"key":"e_1_2_6_14_1","unstructured":"National Records of Scotland Scottish Government.Live Births by Country of Birth of Mother and Administrative Area Scotland. Edinburgh: Scottish Government; 2015. Available from:https:\/\/www.nrscotland.gov.uk\/files\/\/statistics\/vital\u2010events\u2010ref\u2010tables\/2015\/section3\/15\u2010vital\u2010events\u2010ref\u2010tab\u20103\u20109.pdf[accessed 19 July 2017]."},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/archdischild-2016-311020"},{"key":"e_1_2_6_16_1","first-page":"A136","article-title":"G335 post immunisation pyrexia \u2010 What are we doing?","volume":"102","author":"Baxter FA","year":"2017","journal-title":"Arch. Dis. Child."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0000000000000225"}],"container-title":["Journal of Paediatrics and Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjpc.14315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.14315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jpc.14315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jpc.14315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,9]],"date-time":"2023-09-09T17:38:11Z","timestamp":1694281091000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jpc.14315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,28]]},"references-count":16,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1111\/jpc.14315"],"URL":"https:\/\/doi.org\/10.1111\/jpc.14315","archive":["Portico"],"relation":{},"ISSN":["1034-4810","1440-1754"],"issn-type":[{"type":"print","value":"1034-4810"},{"type":"electronic","value":"1440-1754"}],"subject":[],"published":{"date-parts":[[2018,11,28]]},"assertion":[{"value":"2018-05-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-11-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}