Children and adults without a spleen (asplenia)

Some people are born without a spleen, or their spleen does not work properly. Some people have their spleen removed (splenectomy). People without a fully working spleen are at increased risk of some life threatening infections.

Questions and answers

What does the spleen do?
What should I do if I do not have a fully working spleen?
Which vaccines do I need?
Do I need to take antibiotics?
What should I do if I become ill?
What should I do if I plan to travel?

What does the spleen do?

The spleen helps to protect the body against infections caused by bacteria. If you do not have a spleen you will still be able to cope with most infections but, in some cases, serious infection may develop quickly. The risk of this happening is higher in children than in adults, though still very small. Let your child’s school know if they are affected.

What should I do if I do not have a fully working spleen?

  • Carry a card or wear an identifying bracelet or necklace to alert other people in an emergency.
  • Make sure that your doctors, nurses and dentist know you do not have a fully working spleen. Remind health professionals each time you’re in contact with them, including NHS 24.
  • Take antibiotics if recommended.
  • Make sure you have had all the routine vaccines recommended for everyone.
  • Also make sure you have had the extra vaccines and boosters recommended for people without a spleen.

Which vaccines do I need?

Make sure you have had all your routine immunisations. People without a fully working spleen should also have the following extra immunisations:

  • Pneumococcal vaccine
  • Haemophilus influenzae type b and Meningococcal  C vaccine (Hib/MenC)
  • Meningococcal ACWY conjugate vaccine (Men ACWY)
  • Meningococcal  B vaccine (MenB)
  • Influenza vaccine (flu) every year

The flu vaccine helps reduce your risk of developing complications if you do catch flu. Speak to your GP, practice nurse or health visitor so they can check what you need.

Do I need to take antibiotics?

For some people who don’t have a fully working spleen, taking lifelong antibiotics is recommended.

  • If your GP recommends it, you should take antibiotics every day to help prevent infection.
  • You should also have a course of different antibiotics to keep at home, in case you become ill.

What should I do if I become ill?

It is important to consult your GP quickly if you are ill. Most illnesses can be dealt with as usual, but sometimes a fever, sore throat, headache, abdominal pain or rash may be the beginning of an infection. This can be more serious for anyone without a fully working spleen, so always get medical advice if you’re unwell.

If you ever call NHS 24 on 111 for advice, remember to tell them that you don’t have a working spleen.

What should I do if I plan to travel? 

When travelling you are at increased risk of getting certain infections or becoming more unwell if you get them, including malaria and diseases that you can catch from ticks or animal bites. If you’re going abroad (including to Europe or USA, trekking or camping):

  • Get advice from your GP, practice nurse or travel clinic with plenty of time before your trip (6–8 weeks).
  • Destinations with malaria are particularly risky and you will need special advice on this.
  • You may need specialist advice – extra vaccines and additional precautions may be necessary.
  • It is wise to carry a course of antibiotics with you.
  • If you become ill, get medical advice quickly.
  • You are at greater risk from diseases passed by ticks, so avoid being bitten (clothing, repellents).
  • Animal bites (especially from a dog) should be treated urgently.
  • Ensure that your travel insurance covers your health needs.

People without a working spleen are at risk of overwhelming infections including pneumonia, septicaemia (blood poisoning) and meningitis. After completing the details for yourself or your young child, please carry this card with you at all times so that paramedics and other health professionals are aware of your (or your child’s) condition in case of illness.

For more information on travel vaccines, visit the Fit for Travel website. 

Last reviewed on 29 February 2016

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