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Human Vaccines & Immunotherapeutics Jun 2013Meningococcal disease remains a devastating and feared infection with a significant morbidity and mortality profile. The successful impact of meningococcal capsular... (Review)
Review
Meningococcal disease remains a devastating and feared infection with a significant morbidity and mortality profile. The successful impact of meningococcal capsular group C glyconconjugate vaccines introduced into the UK infant immunization schedule in 1999, has resulted in >80% of disease now being attributable to meningococcal capsular group B (MenB). MenB glyconconjugate vaccines are not immunogenic and hence, vaccine design has focused on sub-capsular antigens. Recently, a four component vaccine to combat MenB disease (4CMenB) has progressed through clinical development and was approved by the European Medicines Agency at the end of 2012. This vaccine has proven safe and immunogenic and has been predicted to provide protection against ~73% of the MenB disease from England and Wales. Recommendation/implementation of the vaccine into the UK infant schedule is currently being evaluated. 4CMenB has the potential to provide protection against a significant proportion of MenB disease in the UK which is currently unpreventable.
Topics: Clinical Trials as Topic; Drug Approval; Humans; Immunization Schedule; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis, Serogroup B; United Kingdom; Vaccines, Conjugate
PubMed: 23732894
DOI: 10.4161/hv.24689 -
Human Vaccines & Immunotherapeutics Apr 2016Neisseria meningitidis may cause invasive disease (meningitis and sepsis), leading to considerable disease burden and mortality. However, effective vaccines are... (Review)
Review
Neisseria meningitidis may cause invasive disease (meningitis and sepsis), leading to considerable disease burden and mortality. However, effective vaccines are available against most pathogenic serogroups. Large-scale vaccination campaigns with the MCC vaccine conducted in UK and with MenAfriVac in the Sahel have clearly demonstrated the direct and indirect effect of immunization programmes on disease and carriage. Moreover, the introduction of novel subcapsular vaccines against serogroup B, which may cross-protect against other serogroups, is likely to have a further effect on trends. Accurate data collection is key to elaborate vaccination strategies able to reduce meningococcal disease burden through direct protection and herd immunity.
Topics: Africa; Antigens, Bacterial; Cross Protection; Humans; Immunity, Herd; Immunization Programs; Meningitis, Meningococcal; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Serogroup; Vaccination
PubMed: 26512927
DOI: 10.1080/21645515.2015.1108502 -
Revista Espanola de Quimioterapia :... Oct 2021
Topics: Arthritis, Infectious; Humans; Meningitis, Meningococcal; Meningococcal Infections
PubMed: 34304434
DOI: 10.37201/req/056.2021 -
Human Vaccines & Immunotherapeutics Dec 2023Invasive meningococcal disease is a life-threatening infection preventable through vaccination. Pediatric vaccination rates have declined during the coronavirus disease...
Invasive meningococcal disease is a life-threatening infection preventable through vaccination. Pediatric vaccination rates have declined during the coronavirus disease 2019 (COVID-19) pandemic. This survey aimed to understand how parents' attitudes and behaviors have changed during the pandemic with regard to immunization and, more specifically, meningococcal vaccination. An online survey was emailed to parents of eligible children 0-4 years, following the selection process from UK, France, Germany, Italy, Brazil, Argentina, and Australia; and of adolescents 11-18 years from US. Data collection took place 19 January-16 February 2021. Quotas were set to ensure a representative sample. Eleven questions relating to general perceptions around vaccination and attitudes and behaviors toward meningitis vaccination were displayed. On 4,962 parents (average 35 years) participating in the survey, most (83%) believed important for their child to continue receiving recommended vaccines during the COVID-19 pandemic. Nearly half of routine vaccine appointments were delayed or canceled due to the pandemic, and 61% of respondents were likely to have their children catch up once COVID-19 restrictions were lifted. 30% of meningitidis vaccination appointments were canceled or delayed during the pandemic, and 21% of parents did not intend to reschedule them because of lockdown/stay at home regulations, and fear of catching COVID-19 in public places. It is crucial to communicate clear instructions to health workers and the general population and to provide appropriate safety precautions in vaccination centers. This will help to maintain vaccination rates and limit infections to prevent future outbreaks.
Topics: Adolescent; Humans; Child; Pandemics; Health Knowledge, Attitudes, Practice; COVID-19; Communicable Disease Control; Meningococcal Infections; Vaccination; Meningococcal Vaccines; Surveys and Questionnaires; Parents
PubMed: 36883777
DOI: 10.1080/21645515.2023.2179840 -
International Journal of Environmental... Mar 2022Meningococcal disease is caused by ; 13 serogroups have been identified and differentiated from each other through their capsular polysaccharide. Serotypes A, B, C, W,...
Meningococcal disease is caused by ; 13 serogroups have been identified and differentiated from each other through their capsular polysaccharide. Serotypes A, B, C, W, X, and Y are responsible for nearly all infections worldwide. The most common clinical manifestations are meningitis and invasive meningococcal disease, both characterized by high mortality and long-term sequelae. The infection rate is higher in children younger than 1 year and in adolescents, who are frequently asymptomatic carriers. Vaccination is the most effective method of preventing infection and transmission. Currently, both monovalent meningococcal vaccines (against A, B, and C serotypes) and quadrivalent meningococcal vaccines (against serogroups ACYW) are available and recommended according to local epidemiology. The purpose of this article is to describe the meningococcal vaccines and to identify instruments that are useful for reducing transmission and implementing the vaccination coverage. This aim could be reached by switching from the monovalent to the quadrivalent vaccine in the first year of life, increasing vaccine promotion against ACYW serotypes among adolescents, and extending the free offer of the anti-meningococcal B vaccine to teens, co-administering it with others proposed in the same age group. Greater awareness of the severity of the disease and increased health education through web and social networks could represent the best strategies for promoting adhesion and active participation in the vaccination campaign. Finally, the development of a licensed universal meningococcal vaccine should be another important objective.
Topics: Adolescent; Child; Humans; Immunization Programs; Meningitis, Meningococcal; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Vaccination; Vaccines, Conjugate
PubMed: 35409716
DOI: 10.3390/ijerph19074035 -
Expert Review of Vaccines Dec 2011Meningococcal disease is characterized by a marked variation in incidence and serogroup distribution by region and over time. In several European countries, Canada and... (Review)
Review
Meningococcal disease is characterized by a marked variation in incidence and serogroup distribution by region and over time. In several European countries, Canada and Australia, immunization programs, including universal vaccination of infants or toddlers with catch-up campaigns in children and adolescents, aimed at controlling disease caused by meningococcal serogroup C have been successful in reducing disease incidence through direct and indirect protection. More recently, meningococcal conjugate vaccines targeting disease caused by serogroups A, C, W-135 and Y have been licensed and are being used in adolescent programs in the USA and Canada while a mass immunization campaign against serogroup A disease has been implemented in Africa. Positive results from clinical trials using vaccines against serogroup B disease in various age groups suggest the possibility of providing broader protection against serogroup B disease than is provided by the currently used outer membrane vesicle vaccines. The purpose of our review of meningococcal epidemiology and assessment of existing policies is to set the stage for future policy decisions. Vaccination policies to prevent meningococcal disease in different regions of the world should be based on quality information from enhanced surveillance systems.
Topics: Communicable Disease Control; Geography; Health Policy; Humans; Immunization Programs; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Travel
PubMed: 22085175
DOI: 10.1586/erv.11.159 -
Human Vaccines & Immunotherapeutics Jun 2020
Topics: Humans; Meningitis, Meningococcal; Meningococcal Infections; Meningococcal Vaccines; Vaccines, Conjugate
PubMed: 32598245
DOI: 10.1080/21645515.2020.1752558 -
British Medical Journal Apr 1976Serum C3 levels were measured in 211 patients with meningococcal disease. Low levels were found in 13 patients with acute meningococcaemia, and complement activation may...
Serum C3 levels were measured in 211 patients with meningococcal disease. Low levels were found in 13 patients with acute meningococcaemia, and complement activation may have contributed to the peripheral circulatory collapse that was responsible for nine deaths. The complement profile of these patients suggested activation of both classical and alternative complement pathways. Patients with meningitis had a higher mean serum C3 level than controls. Serial studies in 13 serum antigen-positive patients with meningitis who subsequently developed arthritis or cutaneous vasculitis showed a transient fall in serum C3 in eight. This fall was probably due to the formation of immune complexes that were responsible for their allergic complications.
Topics: Adult; Antibodies, Bacterial; Antigen-Antibody Complex; Antigens, Bacterial; Arthritis; Complement C1; Complement C3; Complement C4; Complement System Proteins; Humans; Meningitis, Meningococcal; Meningococcal Infections; Properdin; Synovial Fluid; Vascular Diseases
PubMed: 1260336
DOI: 10.1136/bmj.1.6013.797 -
Ugeskrift For Laeger Sep 2017Meningococcal disease is a rapidly progressing infection, which continues to cause deaths among children and adolescents. In this review, clinical signs and initial... (Review)
Review
Meningococcal disease is a rapidly progressing infection, which continues to cause deaths among children and adolescents. In this review, clinical signs and initial treatment of acute childhood meningococcal disease is described. Operational flow charts have been developed for assessment of non-blanching rash and initial treatment of meningococcal disease.
Topics: Acute Disease; Adolescent; Algorithms; Child; Child, Preschool; Denmark; Humans; Infant; Meningococcal Infections; Shock, Septic
PubMed: 28874255
DOI: No ID Found -
The Cochrane Database of Systematic... Jun 2017Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by... (Review)
Review
BACKGROUND
Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis.
OBJECTIVES
To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different pre-admission antibiotic regimens in decreasing mortality, clinical failure, and morbidity in people suspected of meningococcal disease.
SEARCH METHODS
We searched CENTRAL (6 January 2017), MEDLINE (1966 to 6 January 2017), Embase (1980 to 6 January 2017), Web of Science (1985 to 6 January 2017), LILACS (1982 to 6 January 2017), and prospective trial registries to January 2017. We previously searched CAB Abstracts from 1985 to June 2015, but did not update this search in January 2017.
SELECTION CRITERIA
Randomised controlled trials (RCTs) or quasi-RCTs comparing antibiotics versus placebo or no intervention, in people with suspected meningococcal infection, or different antibiotics administered before admission to hospital or confirmation of the diagnosis.
DATA COLLECTION AND ANALYSIS
Two review authors independently assessed trial quality and extracted data from the search results. We calculated the risk ratio (RR) and 95% confidence interval (CI) for dichotomous data. We included only one trial and so did not perform data synthesis. We assessed the overall quality of the evidence using the GRADE approach.
MAIN RESULTS
We found no RCTs comparing pre-admission antibiotics versus no pre-admission antibiotics or placebo. We included one open-label, non-inferiority RCT with 510 participants, conducted during an epidemic in Niger, evaluating a single dose of intramuscular ceftriaxone versus a single dose of intramuscular long-acting (oily) chloramphenicol. Ceftriaxone was not inferior to chloramphenicol in reducing mortality (RR 1.21, 95% CI 0.57 to 2.56; N = 503; 308 confirmed meningococcal meningitis; 26 deaths; moderate-quality evidence), clinical failures (RR 0.83, 95% CI 0.32 to 2.15; N = 477; 18 clinical failures; moderate-quality evidence), or neurological sequelae (RR 1.29, 95% CI 0.63 to 2.62; N = 477; 29 with sequelae; low-quality evidence). No adverse effects of treatment were reported. Estimated treatment costs were similar. No data were available on disease burden due to sequelae.
AUTHORS' CONCLUSIONS
We found no reliable evidence to support the use pre-admission antibiotics for suspected cases of non-severe meningococcal disease. Moderate-quality evidence from one RCT indicated that single intramuscular injections of ceftriaxone and long-acting chloramphenicol were equally effective, safe, and economical in reducing serious outcomes. The choice between these antibiotics should be based on affordability, availability, and patterns of antibiotic resistance.Further RCTs comparing different pre-admission antibiotics, accompanied by intensive supportive measures, are ethically justified in people with less severe illness, and are needed to provide reliable evidence in different clinical settings.
Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Ceftriaxone; Chloramphenicol; Humans; Injections, Intramuscular; Meningitis, Meningococcal; Meningococcal Infections; Patient Admission
PubMed: 28613408
DOI: 10.1002/14651858.CD005437.pub4