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Expert Review of Vaccines 2024The epidemiology of invasive meningococcal disease (IMD), a rare but potentially fatal illness, is typically described as unpredictable and subject to sporadic outbreaks. (Review)
Review
INTRODUCTION
The epidemiology of invasive meningococcal disease (IMD), a rare but potentially fatal illness, is typically described as unpredictable and subject to sporadic outbreaks.
AREAS COVERED
Meningococcal epidemiology and vaccine use during the last ~ 200 years are examined within the context of meningococcal characterization and classification to guide future IMD prevention efforts.
EXPERT OPINION
Historical and contemporary data highlight the dynamic nature of meningococcal epidemiology, with continued emergence of hyperinvasive clones and affected regions. Recent shifts include global increases in serogroup W disease, meningococcal antimicrobial resistance (AMR), and meningococcal urethritis; additionally, unvaccinated populations have experienced disease resurgences following lifting of COVID-19 restrictions. Despite these changes, a close analysis of meningococcal epidemiology indicates consistent dominance of serogroups A, B, C, W, and Y and elevated IMD rates among infants and young children, adolescents/young adults, and older adults. Demonstrably effective vaccines against all 5 major disease-causing serogroups are available, and their prophylactic use represents a powerful weapon against IMD, including AMR. The World Health Organization's goal of defeating meningitis by the year 2030 demands broad protection against IMD, which in turn indicates an urgent need to expand meningococcal vaccination programs across major disease-causing serogroups and age-related risk groups.
Topics: Child; Infant; Adolescent; Young Adult; Humans; Child, Preschool; Aged; Neisseria meningitidis; Meningococcal Infections; Meningococcal Vaccines; Disease Outbreaks; Serogroup; Vaccines, Combined
PubMed: 38517733
DOI: 10.1080/14760584.2024.2329618 -
Revista Espanola de Quimioterapia :... Aug 2024Meningococcal meningitis (MM) and invasive meningococcal disease remain a major public health problem that generates enormous public alarm. It is caused by Neisseria... (Review)
Review
Meningococcal meningitis (MM) and invasive meningococcal disease remain a major public health problem that generates enormous public alarm. It is caused by Neisseria meningitidis, a Gram-negative diplococcus with an enormous capacity for acute and rapidly progressive disease, both episodic and epidemic in nature, with early diagnosis and treatment playing a major role. It occurs at any age, but is most common in children under 5 years of age followed by adolescents. Although most cases occur in healthy people, the incidence is higher in certain risk groups. Despite advances in reducing the incidence, it is estimated that in 2017 there were around 5 million new cases of MM worldwide, causing approximately 290,000 deaths and a cumulative loss of about 20,000,000 years of healthy life. In Spain, in the 2021/22 season, 108 microbiologically confirmed cases of MM were reported, corresponding to an incidence rate of 0.23 cases per 100,000 inhabitants. This is a curable and, above all, vaccine-preventable disease, for which the World Health Organisation has drawn up a roadmap with the aim of reducing mortality and sequelae by 2030. For all these reasons, the Illustrious Official College of Physicians of Madrid (ICOMEM) and the Medical Associations of 8 other provinces of Spain, have prepared this opinion document on the situation of MM in Spain and the resources and preparation for the fight against it in our country. The COVID-19 and Emerging Pathogens Committee of ICOMEM has invited experts in the field to participate in the elaboration of this document.
Topics: Humans; Spain; Meningitis, Meningococcal; Incidence; Meningococcal Vaccines; Neisseria meningitidis; Child; Child, Preschool; Adolescent
PubMed: 38515374
DOI: 10.37201/req/023.2024 -
Cureus Feb 2024Background Invasive meningococcal disease (IMD) is a bacterial infection caused by Neisseria meningitidis, which primarily affects the meninges, with a high incidence in...
Background Invasive meningococcal disease (IMD) is a bacterial infection caused by Neisseria meningitidis, which primarily affects the meninges, with a high incidence in young children. The most effective technique for preventing IMD is vaccination, which has been available for over 40 years through meningococcal polysaccharide capsule-containing vaccines. This study aims to assess the parental knowledge of meningococcal disease and vaccination in the Makkah region of Saudi Arabia. Methodology A cross-sectional study was conducted between September and December 2023 among 597 parents in the Makkah region using a validated online survey. The collected data were analyzed using the Statistical Package for the Social Sciences (SPSS). Results The study sample included 597 parents, of which 339 (56.8%) were female and 258 (43.2%) were male. Our research demonstrated that 388 (65%) participants had an insufficient understanding of IMD, while 209 (35%) had a sufficient understanding. There was a significant correlation between the knowledge score and the completion of the routine vaccination and whether vaccinating a child is essential for the protection of other members of society. Conclusions Based on our study, only around one-third of the participants demonstrated a sufficient level of knowledge regarding IMD and its vaccination. To provide a more accurate assessment of the Saudi population, additional research should be conducted in various regions and cities.
PubMed: 38510876
DOI: 10.7759/cureus.54450 -
Vaccine Apr 2024Investigating the mechanisms by which W135 meningococcal conjugate (PSW135-TT) activates adaptive immune responses in mice can provide a comprehensive understanding of...
Investigating the mechanisms by which W135 meningococcal conjugate (PSW135-TT) activates adaptive immune responses in mice can provide a comprehensive understanding of the immune mechanisms of bacterial polysaccharide conjugate vaccines. We compared B-cell and T-cell immune responses immunized with W135 meningococcal capsular polysaccharides (PSW135), tetanus toxoid (TT) and PSW135-TT in mice. The results showed that PSW135-TT could induce higher PSW135-specific and TT-specific IgG antibodies with a significant enhancement after two doses. All serum antibodies immunized with PSW135- TT had strong bactericidal activity, whereas none of the serum antibodies immunized with PSW135 had bactericidal activity. Besides, IgM and IgG antibodies immunized with PSW135-TT after two doses were positively correlated with the titer of bactericidal antibodies. We also found Th cells favored Th2 humoral immune responses in PSW135-TT, PSW135, and TT-immunized mice, especially peripheral blood lymphocytes. Furthermore, PSW135-TT and TT could effectively activate bone marrow derived dendritic cells (BMDCs) and promote BMDCs to highly express major histocompatibility complex Ⅱ (MHCⅡ), CD86 and CD40 molecules in mice, whereas PSW135 couldn't. These data verified the typical characteristics of PSW135-TT and TT as T cell dependent antigen (TD-Ag) and PSW135 as T cell independent antigen (TI-Ag), which will be very helpful for further exploration of the immune mechanism of polysaccharide-protein conjugate vaccines and improvement of the quality of bacterial polysaccharide conjugate vaccines in future.
Topics: Animals; Mice; Neisseria meningitidis, Serogroup W-135; Serogroup; Tetanus Toxoid; Meningococcal Vaccines; Polysaccharides, Bacterial; Vaccines, Conjugate; Antibodies, Bacterial; Immunity, Cellular; Immunoglobulin G; Meningococcal Infections
PubMed: 38508928
DOI: 10.1016/j.vaccine.2024.03.039 -
The Medical Letter on Drugs and... Mar 2024
Topics: Humans; Meningococcal Vaccines; Vaccines, Combined; Bacterial Vaccines
PubMed: 38466212
DOI: 10.58347/tml.2024.1698b -
Canada Communicable Disease Report =... Sep 2023Following recent outbreaks of invasive meningococcal disease (IMD) in Canada and updates to provincial vaccination guidelines, the National Advisory Committee on...
A National Advisory Committee on Immunization (NACI) update on invasive meningococcal disease (IMD) epidemiology and program-relevant considerations for preventing IMD in individuals at high risk of exposure.
Following recent outbreaks of invasive meningococcal disease (IMD) in Canada and updates to provincial vaccination guidelines, the National Advisory Committee on Immunization (NACI) conducted a targeted review of evidence with a focus on immunization of adolescents and young adults. NACI reviewed national and international immunization recommendations for populations at high-risk of IMD, national IMD epidemiology and program-relevant considerations. Given the varied IMD epidemiology, NACI determined that recommending a pan-Canadian targeted program is currently challenging and that regional programs may be better suited to prevent IMD in population groups considered to be at high-risk of exposure. Further data is needed to ascertain contemporary risk factors for IMD (including activities and settings associated with bacterial acquisition, carriage and transmission) and estimate the true cost of meningococcal vaccine-preventable infections in Canada. To support provinces and territories in their decision-making, an outline of program-relevant elements for provincial and territorial consideration is provided.
PubMed: 38463903
DOI: 10.14745/ccdr.v49i09a01 -
Frontiers in Immunology 2024Outer membrane vesicles (OMVs) of in the group B-directed vaccine MenB-4C (Bexsero) protect against infections with . The immunological basis for protection remains...
INTRODUCTION
Outer membrane vesicles (OMVs) of in the group B-directed vaccine MenB-4C (Bexsero) protect against infections with . The immunological basis for protection remains unclear. OMV vaccines generate human antibodies to and lipooligosaccharide (LOS/endotoxin), but the structural specificity of these LOS antibodies is not defined.
METHODS
Ten paired human sera obtained pre- and post-MenB-4C immunization were used in Western blots to probe and LOS. Post-MenB-4C sera (7v5, 19v5, and 17v5), representing individual human variability in LOS recognition, were then used to interrogate structurally defined LOSs of and strains and mutants and studied in bactericidal assays.
RESULTS AND DISCUSSION
Post-MenB-4C sera recognized both and LOS species, ~10% of total IgG to gonococcal OMV antigens. and LOSs were broadly recognized by post-IgG antibodies, but with individual variability for LOS structures. Deep truncation of LOS, specifically a K mutant without -, -, or -chain glycosylation, eliminated LOS recognition by all post-vaccine sera. Serum 7v5 IgG antibodies recognized the unsialyated L1 -chain, and a 3-PEA-HepII or 6-PEA-HepII was part of the conformational epitope. Replacing the 3-PEA on HepII with a 3-Glc blocked 7v5 IgG antibody recognition of and LOSs. Serum 19v5 recognized lactoneotetrose (LNT) or L1 LOS-expressing or with a minimal -chain structure of Gal-Glc-HepI (L8), a 3-PEA-HepII or 6-PEA-HepII was again part of the conformational epitope and a 3-Glc-HepII blocked 19v5 antibody binding. Serum 17v5 LOS antibodies recognized LNT or L1 -chains with a minimal HepI structure of three sugars and no requirement for HepII modifications. These LOS antibodies contributed to the serum bactericidal activity against . The MenB-4C vaccination elicits bactericidal IgG antibodies to conformational epitopes involving HepI and HepII glycosylated LOS structures shared between and LOS structures should be considered in next-generation gonococcal vaccine design.
Topics: Humans; Immunoglobulin G; Neisseria gonorrhoeae; Polysaccharides; Anti-Bacterial Agents; Antigens, Bacterial; Epitopes; Lipopolysaccharides
PubMed: 38440731
DOI: 10.3389/fimmu.2024.1350344 -
Journal of Chromatography. B,... Apr 2024Molecular size distribution (MSD) of polysaccharides serves as a key parameter that directly correlates to the immunogenicity of vaccine. MSD at meningococcal...
Molecular size distribution in pentavalent (A, C, Y, W, X) meningococcal polysaccharide conjugate vaccine by HPSEC-UV-MALS-RI method- a conceivable stability indicating parameter.
Molecular size distribution (MSD) of polysaccharides serves as a key parameter that directly correlates to the immunogenicity of vaccine. MSD at meningococcal polysaccharide (A, C, Y and W) or conjugate bulk level is well established under detailed pharmacopeial and WHO guidelines. We report here, a newly developed method for determination of molecular size distribution of pentavalent Meningococcal conjugate vaccine comprising of A, C, Y, W and X (MenFive). Although serogroup specific molecular size could not be estimated here; lot to lot consistency monitoring, molecular aggregates distribution in final lot, are key takeaways of this method. Determination of MSD in pentavalent fill finished product was quite challenging. Various columns/detectors combination, buffers, physico-chemical conditions (temperature, 2-8 °C, 25 °C, 40 °C and 60 °C; flow rate, 0.3 mL to 0.8 mL), liquid/lyophilized formulations, were explored. Polymer-based packed columns were explored for estimation for MSD by aqueous size exclusion chromatography, using combinations of- Shodex OHPAK SB 807 HQ, Shodex OHPAK SB 806 HQ, G6000 PWXL, coupled with guard Shodex OHPAK SB-G-6B. MenFive showed heterogenous distribution of molecules ranging from 200 to 19000 kDa, indicating its complex nature. However, 1000-8000 kDa was dominant range, comprising of ≥ 50 % distribution of molecules, in both liquid as well as lyophilized formulations, with average molecular weight around 6000-6500 kDa. The molar mass distribution after slicing would provide an insight to the conformation of molecules through its presentation as HMW, LMW, aggregates and subsequently, the presence of dominant population of molecules of a particular molecular weight and its total contribution in the sample.
Topics: Meningococcal Vaccines; Vaccines, Conjugate; Polysaccharides; Chromatography, Gel; Molecular Weight; Antibodies, Bacterial
PubMed: 38430603
DOI: 10.1016/j.jchromb.2024.124048 -
Infectious Diseases and Therapy Mar 2024An advisory board meeting was held with experts in Vietnam (Hanoi, August 2022), to review the evidence on invasive meningococcal disease (IMD) epidemiology, clinical...
An advisory board meeting was held with experts in Vietnam (Hanoi, August 2022), to review the evidence on invasive meningococcal disease (IMD) epidemiology, clinical management, and meningococcal vaccines to reach a consensus on recommendations for meningococcal vaccination in Vietnam. IMD is a severe disease, with the highest burden in infants and children. IMD presents as meningitis and/or meningococcemia and can progress extremely rapidly. Almost 90% of deaths in children occur within the first 24 h, and disabling sequelae (e.g., limb amputations and neurological damage) occur in up to 20% of survivors. IMD patients are often hospitalized late, due to mild and nonspecific early symptoms and misdiagnosis. Difficulties related to diagnosis and antibiotic misuse mean that the number of reported IMD cases in Vietnam is likely to be underestimated. Serogroup B IMD is predominant in many regions of the world, including Vietnam, where 82% of IMD cases were due to serogroup B (surveillance data from 2012 to 2021). Four component meningococcal B vaccine (4CMenB) is used in many countries (and is part of the pediatric National Immunization Program in 13 countries), with infant vaccination starting from two months of age, and a 2 + 1 dosing schedule. Experts recommend 4CMenB vaccination as soon as possible in Vietnam, starting from two months of age, with a 2 + 1 dosing schedule, and at least completing one dose before 6 months of age.
PubMed: 38430327
DOI: 10.1007/s40121-023-00905-y -
The Journal of Adolescent Health :... Jun 2024Invasive meningococcal disease (IMD) is a rare but serious illness, and adolescents and young adults in the United States are at increased risk. Here, we discuss US IMD... (Review)
Review
Invasive meningococcal disease (IMD) is a rare but serious illness, and adolescents and young adults in the United States are at increased risk. Here, we discuss US IMD history and how successful disease prevention through routine vaccination against the most common disease-causing serogroups (A, B, C, W, and Y) can inform future recommendations. Before the introduction of quadrivalent meningococcal conjugate (MenACWY) vaccines, most US cases of IMD were caused by serogroups B, C, and Y. After recommendation by the Advisory Committee on Immunization Practices for routine MenACWY vaccination of 11-12-year-olds in 2005, followed by a 2010 booster recommendation, MenCWY disease incidence declined dramatically, and vaccine coverage remains high. Two serogroup B (MenB) vaccines are licensed in the United States, but uptake is low compared with MenACWY vaccines, likely because Advisory Committee on Immunization Practices recommends MenB vaccination subject to shared clinical decision-making rather than routinely for all adolescents. The proportion of adolescent IMD caused by MenB has now increased. Pentavalent vaccines that protect against serogroups A, B, C, W, and Y may provide an optimal strategy for improving vaccination rates to ultimately reduce MenB incidence while maintaining the historically low rates of IMD caused by serogroups A, C, W, and Y.
Topics: Humans; Meningococcal Vaccines; United States; Adolescent; Meningococcal Infections; Vaccines, Conjugate; Vaccination; Neisseria meningitidis; Child
PubMed: 38430074
DOI: 10.1016/j.jadohealth.2024.01.016