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MMWR. Morbidity and Mortality Weekly... Jul 2017Use of eculizumab (Soliris, Alexion Pharmaceuticals), a terminal complement inhibitor, is associated with a 1,000-fold to 2,000-fold increased incidence of meningococcal...
Use of eculizumab (Soliris, Alexion Pharmaceuticals), a terminal complement inhibitor, is associated with a 1,000-fold to 2,000-fold increased incidence of meningococcal disease (1). Administration of meningococcal vaccines is recommended for patients receiving eculizumab before beginning treatment (2,3). Sixteen cases of meningococcal disease were identified in eculizumab recipients in the United States during 2008-2016; among these, 11 were caused by nongroupable Neisseria meningitidis. Fourteen patients had documentation of receipt of at least 1 dose of meningococcal vaccine before disease onset. Because eculizumab recipients remain at risk for meningococcal disease even after receipt of meningococcal vaccines, some health care providers in the United States as well as public health agencies in other countries recommend antimicrobial prophylaxis for the duration of eculizumab treatment; a lifelong course of treatment is expected for many patients. Heightened awareness, early care seeking, and rapid treatment of any symptoms consistent with meningococcal disease are essential for all patients receiving eculizumab treatment, regardless of meningococcal vaccination or antimicrobial prophylaxis status.
Topics: Antibodies, Monoclonal, Humanized; Humans; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Risk Assessment; Serogroup; United States
PubMed: 28704351
DOI: 10.15585/mmwr.mm6627e1 -
Serogroup A meningococcal conjugate vaccines: building sustainable and equitable vaccine strategies.Expert Review of Vaccines May 2020For well over 100 years, meningococcal disease due to serogroup A (MenA) has caused severe epidemics globally, especially in the meningitis belt of sub-Saharan Africa. (Review)
Review
INTRODUCTION
For well over 100 years, meningococcal disease due to serogroup A (MenA) has caused severe epidemics globally, especially in the meningitis belt of sub-Saharan Africa.
AREAS COVERED
The article reviews the background and identification of MenA, the global and molecular epidemiology of MenA, and the outbreaks of MenA in the African meningitis belt. The implementation (2010) of an equitable MenA polysaccharide-protein conjugate vaccine (Ps-TT, MenAfriVac) and the strategy to control MenA in sub-Saharan Africa is described. The development of a novel multi-serogroup meningococcal conjugate vaccine (NmCV-5) that includes serogroup A is highlighted. The PubMed database (1996-2019) was searched for studies relating to MenA outbreaks, vaccine, and immunization strategies; and the Neisseria PubMLST database of 1755 MenA isolates (1915-2019) was reviewed.
EXPERT OPINION
Using strategies from the successful MenAfriVac campaign, expanded collaborative partnerships were built to develop a novel, low-cost multivalent component meningococcal vaccine that includes MenA. This vaccine promises greater sustainability and is directed toward global control of meningococcal disease in the African meningitidis belt and beyond. The new WHO global roadmap addresses the continuing problem of bacterial meningitis, including meningococcal vaccine prevention, and provides a framework for further reducing the devastation of MenA.
Topics: Africa South of the Sahara; Disease Outbreaks; Global Health; Humans; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis, Serogroup A; Vaccination
PubMed: 32321332
DOI: 10.1080/14760584.2020.1760097 -
The New England Journal of Medicine Aug 2023
Topics: Humans; Meningococcal Vaccines; Gambia; Mali; Vaccines, Conjugate
PubMed: 37590458
DOI: 10.1056/NEJMc2307375 -
The Journal of Family Practice Aug 2012With the incidence of meningococcal disease declining in all age groups, ACIP is weighing the need for vaccination in children <2 years. (Comparative Study)
Comparative Study Review
With the incidence of meningococcal disease declining in all age groups, ACIP is weighing the need for vaccination in children <2 years.
Topics: Adult; Advisory Committees; Age Distribution; Female; Humans; Immunization Schedule; Infant; Male; Meningococcal Infections; Meningococcal Vaccines; Pediatrics; Prevalence; Risk Assessment; Safety Management; Travel; United States; Vaccination; Vaccines, Conjugate
PubMed: 22871657
DOI: No ID Found -
Expert Opinion on Biological Therapy Dec 2008Neisseria meningitidis is a leading cause of meningitis and sepsis worldwide. Since 1981, a tetravalent meningococcal polysaccharide vaccine has been available in the US... (Review)
Review
BACKGROUND
Neisseria meningitidis is a leading cause of meningitis and sepsis worldwide. Since 1981, a tetravalent meningococcal polysaccharide vaccine has been available in the US but it has been limited to high-risk patients and outbreak settings. In 2005, a tetravalent polysaccharide meningococcal conjugate vaccine (MCV4) was licensed for routine use in the US.
OBJECTIVE
To assess the immunogenicity and safety of MCV4, and to extrapolate the anticipated clinical effectiveness of MCV4 using data from other polysaccharide conjugate vaccination programs.
METHODS
All published controlled studies of MCV4 immunogenicity, safety and cost-effectiveness are analyzed. Publicly-available clinical trial data and the Advisory Committee on Immunization Practices guidelines were also reviewed.
CONCLUSION
MCV4 is as safe and immunogenic as the previously available polysaccharide vaccine, and seems to provide longer lasting protection against meningococcal disease. Long-term studies are continuing and will shed further light on the effectiveness of MCV4 at the population level.
Topics: Adult; Clinical Trials as Topic; Guillain-Barre Syndrome; Humans; Meningococcal Vaccines; Product Surveillance, Postmarketing
PubMed: 18990080
DOI: 10.1517/14712590802538455 -
Drugs Nov 2017MenACWY-TT (Nimenrix) is a quadrivalent meningococcal tetanus toxoid conjugate vaccine licensed in Europe for active immunisation of individuals aged ≥ 6 weeks... (Review)
Review
MenACWY-TT (Nimenrix) is a quadrivalent meningococcal tetanus toxoid conjugate vaccine licensed in Europe for active immunisation of individuals aged ≥ 6 weeks against invasive disease caused by Neisseria meningitidis capsular groups A, C, W and Y. MenACWY-TT is the first quadrivalent conjugate vaccine to be approved in Europe for use in infants as young as 6 weeks of age. Numerous phase II-IIIb clinical studies showed that intramuscular MenACWY-TT administered as primary or booster vaccination was highly immunogenic for all four vaccine capsular groups and had an acceptable reactogenicity profile in individuals aged 6 weeks to ≥ 56 years. MenACWY-TT is as immunogenic and safe as other previously licensed monovalent capsular group C or quadrivalent capsular groups A, C, W and Y meningococcal vaccines and can be coadministered with other routine vaccines without adversely affecting the immunogenicity or safety profiles of either vaccine. Current data indicate that primary and booster vaccination with MenACWY-TT is a valuable and safe option for broadening meningococcal protection against four capsular groups across a broad age range, starting as early as 6 weeks of age.
Topics: Europe; Humans; Immunization, Secondary; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Vaccination; Vaccines, Conjugate
PubMed: 29094312
DOI: 10.1007/s40265-017-0828-8 -
The New England Journal of Medicine Aug 2023
Topics: Humans; Meningococcal Vaccines; Gambia; Mali; Vaccines, Conjugate
PubMed: 37590459
DOI: 10.1056/NEJMc2307375 -
MEDICC Review Oct 2019Every year, meningococcal infection by Neisseria meningitidis causes over 500,000 cases and 85,000 deaths in the world, with 20% of survivors suffering sequelae. In Cuba...
Every year, meningococcal infection by Neisseria meningitidis causes over 500,000 cases and 85,000 deaths in the world, with 20% of survivors suffering sequelae. In Cuba its incidence in 1980 reached 5.9 cases per 100,000 population; about 80% of cases were serogroup B, prompting health authorities to declare meningococcal disease the country's main public health problem. Several provinces reported over 120 cases per 100,000 children aged < 1 year, overwhelmingly serogroup B. At that time, no vaccines existed with proven efficacy against N. meningitidis serogroup B, nor was there a vaccine candidate that could be successful in the short term. By 1989, researchers in Havana had developed a Cuban meningococcal B and C vaccine, VA-MENGOC-BC, the world's first against serogroup B meningococcal disease. Its efficacy of 83% was demonstrated in a prospective, randomized, double-blind, placebo-controlled field study. Vaccine production used vesicle or proteoliposome technology for the first time. The same year, the World Intellectual Property Organization awarded its gold medal to the main authors of the VA-MENGOC-BC patent. The vaccine was used in a mass vaccination campaign and later included in Cuba's National Immunization Program, with a cumulative impact on incidence of serogroup B meningococcal disease greater than 95% (93%-98%). Mass, systematic vaccination shifted the spectrum of meningococcal strains in healthy asymptomatic carriers and strains circulating among population groups toward nonvirulent phenotypes. The disease ceased to be a public health problem in the country. VA-MENGOC-BC is the most widely applied vaccine against serogroup B meningococcal disease in the world. Over 60 million doses have been administered in Latin America. In several countries where it has been applied, in which strains other than the vaccine-targeted strains circulate, VA-MENGOC-BC has demonstrated effectiveness against all (55%-98% in children aged < = 4 years and 73%-100% in children aged > 4 years). The vaccine and its proteoliposome technology have had an impact and continue to have potential, not only for meningococcal disease, but also for development of other vaccines and adjuvants.KEYWORDS Neisseria meningitidis, meningococcal disease, meningo-coccal vaccine, biotechnology, pharmaceutical industry, bacterial menin-gitis, meningococcal meningitis, immunization, vaccination, Cuba.
Topics: Adjuvants, Pharmaceutic; Adolescent; Child; Cuba; Drug Development; History, 20th Century; History, 21st Century; Humans; Hypergammaglobulinemia; Meningococcal Infections; Meningococcal Vaccines
PubMed: 32335565
DOI: 10.37757/MR2019.V21.N4.4 -
Human Vaccines & Immunotherapeutics Dec 2012Meningococcal meningitis is caused by Neisseria meningitidis, a gram-negative, aerobic, encapsulated diplococcus. Meningococci are divided into numerous serogroups based... (Review)
Review
Meningococcal meningitis is caused by Neisseria meningitidis, a gram-negative, aerobic, encapsulated diplococcus. Meningococci are divided into numerous serogroups based on the composition of their capsular polysaccharide (Ps) antigens. At least 13 serogroups have been described: A, B, C, D, 29E, H, I, K, L, W-135, X, Y and Z. Out of these 13, six (A, B, C, W135, X and Y) can cause epidemics. The incubation period averages 3-4 d (range 1-10 d), which is the period of communicability. Bacteria can be found for 2-4 d in the nose and pharynx, and for up to 24 h after starting antibiotics. N. meningitidis is a leading cause of meningitis worldwide and a significant public health problem and dreaded disease in most countries. Morbidity and mortality rates from the disease remain high. Apart from epidemics, at least 1.2 million cases of bacterial meningitis are estimated to occur every year, 135,000 of which are fatal--of these, ~500,000 and ~50,000 respectively are caused by meningococci. Many outbreaks of meningococcal meningitis have been documented, with major outbreaks mainly seen in large cities of northern, western and eastern India like New Delhi, Mumbai, Kolkata and northeastern states. In 2011, 245 people died in India, the vast majority (179) in West Bengal, while 467 and 341 people in 2009 and 2010 respectively died of this disease. The meningococcal conjugate vaccines (MCV) are preferred for reasons of immunogenicity and persistence of immunity but are unavailable in India. Only the quadrivalent and bivalent meningococcal Ps vaccines (MPV) are available in India. The quadrivalent MPV is preferred for Haj pilgrims, international travelers and students in that it provides protection against emerging W-135 and Y disease in these areas. A single-dose 0.5mL injection is recommended.
Topics: Humans; India; Meningitis, Meningococcal; Meningococcal Vaccines; Vaccination; Vaccines, Conjugate
PubMed: 22906940
DOI: 10.4161/hv.21666 -
Archives de Pediatrie : Organe Officiel... Sep 2012
Topics: Congresses as Topic; Developed Countries; Developing Countries; France; Humans; Mass Vaccination; Meningococcal Infections; Meningococcal Vaccines; Pediatrics; Practice Guidelines as Topic; Societies, Medical; Vaccination; Vaccines, Conjugate; World Health Organization
PubMed: 22883365
DOI: 10.1016/S0929-693X(12)71272-1