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Expert Review of Vaccines 2023causes invasive meningococcal disease and, globally, significant morbidity, with serogroup B (MenB) being the most common cause of endemic disease and outbreaks in... (Review)
Review
INTRODUCTION
causes invasive meningococcal disease and, globally, significant morbidity, with serogroup B (MenB) being the most common cause of endemic disease and outbreaks in several regions. Extensive use of the four-component serogroup B meningococcal vaccine (4CMenB; Bexsero, GSK) and its inclusion in immunization programs in several countries have generated substantial safety data during the 9 years since its first authorization in 2013.
AREAS COVERED
4CMenB safety data from clinical trials and post-marketing surveillance studies (2011 to 2022), and spontaneously reported adverse events of medical interest from the GSK global safety database. We discuss these safety findings in relation to the benefit of 4CMenB vaccination and implications for further enhancing vaccine confidence.
EXPERT OPINION
4CMenB has been consistently well tolerated across clinical trials and post-licensure surveillance studies, despite a higher incidence of fever reported in infants than with other pediatric vaccines. Surveillance data have not identified any significant safety issues, consistent with an acceptable safety profile of 4CMenB. These findings highlight the need to balance the risk of relatively common, transient, post-immunization fever with the benefit of affording protection that reduces the risk of uncommon but potentially fatal meningococcal infection.
Topics: Infant; Child; Humans; Meningococcal Infections; Meningococcal Vaccines; Serogroup; Neisseria meningitidis, Serogroup B; Neisseria meningitidis
PubMed: 37278390
DOI: 10.1080/14760584.2023.2222015 -
Microbes and Infection May 2000Neisseria meningitidis, an exclusive pathogen of humans, remains the leading worldwide cause of meningitis and fatal sepsis, usually in otherwise healthy individuals. In... (Review)
Review
Neisseria meningitidis, an exclusive pathogen of humans, remains the leading worldwide cause of meningitis and fatal sepsis, usually in otherwise healthy individuals. In recent years, significant advances have improved our understanding of the epidemiology and genetic basis of meningococcal disease and led to progress in the development of the next generation of meningococcal vaccines. This review summarizes current knowledge of the human susceptibility to and the epidemiology and molecular pathogenesis of meningococcal disease.
Topics: Adult; Child; Disease Susceptibility; Humans; Meningitis, Meningococcal; Meningococcal Infections; Neisseria meningitidis; Virulence
PubMed: 10884620
DOI: 10.1016/s1286-4579(00)00356-7 -
BMC Infectious Diseases Dec 2021Baseline hospitalization, mortality, and in-hospital fatality rates for meningococcal infection are required to evaluate preventive interventions, such as the inclusion...
BACKGROUND
Baseline hospitalization, mortality, and in-hospital fatality rates for meningococcal infection are required to evaluate preventive interventions, such as the inclusion of the conjugated quadrivalent meningococcal vaccine and serogroup B based protein vaccines.
METHODS
All meningococcal infection-related hospitalizations in any diagnostic position in Spain from 1st January 1997 through 31st December 2018 were analysed. The annual hospitalization rate, mortality rate and case-fatality rate were calculated.
RESULTS
The average hospitalization rate for meningococcal infection was 1.64 (95% CI 1.61 to 1.66) hospitalizations per 100,000 inhabitants during the study period and significantly decreased from 1997 to 2018. Hospitalizations for meningococcal infection decreased significantly with age and were concentrated in children under 5 years of age (46%). The hospitalization rates reached 29 per 100,000 and 24 per 100,000 children under 1 and 2 years of age, respectively. The in-hospital case-fatality rate was 7.45% (95% CI 7.03 to 7.86). Thirty percent of the deaths occurred in children under 5 years of age, and more than half occurred in adults. The case fatality rate increased significantly with age (p < 0.001).
CONCLUSION
It is necessary to maintain epidemiological surveillance of meningococcal infection to determine the main circulating serogroups involved, track their evolution, and evaluate preventive measures whose effectiveness must be assessed in all age groups.
Topics: Adult; Child; Child, Preschool; Hospitalization; Humans; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Spain
PubMed: 34872512
DOI: 10.1186/s12879-021-06916-9 -
Clinical Microbiology Reviews Jan 2006Neisseria meningitidis is the leading cause of bacterial meningitis in the United States and worldwide. A serogroup A/C/W-135/Y polysaccharide meningococcal vaccine has... (Review)
Review
Neisseria meningitidis is the leading cause of bacterial meningitis in the United States and worldwide. A serogroup A/C/W-135/Y polysaccharide meningococcal vaccine has been licensed in the United States since 1981 but has not been used universally outside of the military. On 14 January 2005, a polysaccharide conjugate vaccine that covers meningococcal serogroups A, C, W-135, and Y was licensed in the United States for 11- to 55-year-olds and is now recommended for the routine immunization of adolescents and other high-risk groups. This review covers the changing epidemiology of meningococcal disease in the United States, issues related to vaccine prevention, and recommendations on the use of the new vaccine.
Topics: Adolescent; Adult; Child; Child, Preschool; Drug Design; Humans; Meningococcal Infections; Meningococcal Vaccines; Middle Aged; Neisseria meningitidis; Serotyping; Vaccination; Vaccines, Conjugate
PubMed: 16418528
DOI: 10.1128/CMR.19.1.142-164.2006 -
Human Vaccines & Immunotherapeutics Nov 2020Globally, there is an increasing number of international migrants. The majority are forced displaced refugees and children unaccompanied by a caregiver, and have limited...
Globally, there is an increasing number of international migrants. The majority are forced displaced refugees and children unaccompanied by a caregiver, and have limited access to essential public health interventions. Routine vaccination might be interrupted or be incomplete due to conflict areas with limited public health services or a long-unplanned journey. Refugees and migrants may bring infectious disease risks to their country of destination and may be exposed to new risk factors during transit or at their destination. There are lessons learned strategies among refugees and asylum seekers in different countries (vaccination campaign during outbreak, maintain vaccination systems for refugees and medical screening and/or vaccination on arrival) against vaccine-preventable diseases - other than meningococcal infections. Since the 1980s, invasive meningococcal disease (IMD) has been reported as a critical healthcare issue in places of humanitarian crisis such as Thailand and African's meningitis belt. Refugees and migrants are at increased risk of IMD compared with the overall population due to sero-epidemiology in their country of origin, specific characteristics of the IMD, and a number of contacts during the journey. Recently, IMD cases due to serogroups X and W have been reported and are an emerging health threat for persons arriving from Africa to refugee camps in Italy. There have been sporadic case reports of IMD due to serogroup B in Turkey; however, there has not yet been increased disease activity in this population and no outbreaks have been observed. Outbreaks of IMD in refugee camps have been and could be successfully controlled through the implementation of timely and high-coverage vaccination campaigns, and individual cases of IMD can be treated with antibiotics. Research is needed to determine the prevalence of meningococcal carriage and serogroup distribution among refugees and migrants to inform vaccine recommendations. There is no official recommendation for meningococcal vaccination of refugees. Further strategies for prevention and treatment of human immunodeficiency virus, tuberculosis and antibiotic resistance among refugees are directly related to potential prevention methods for IMD. Meningococcal vaccines have been administered only to risk groups in most host countries Thus, further strategies for the definition of new/emerging risk factors for IMD would be helpful to guide vaccine implementation for refugees and immigrants.
Topics: Africa; Child; Emigrants and Immigrants; Humans; Italy; Meningitis, Meningococcal; Meningococcal Infections; Meningococcal Vaccines; Refugees; Thailand; Turkey
PubMed: 32347773
DOI: 10.1080/21645515.2020.1744979 -
British Medical Journal Oct 1979
Topics: Child; Humans; Infant; Meningococcal Infections; Penicillin G; Sepsis
PubMed: 509172
DOI: No ID Found -
Revista Brasileira de Ginecologia E... Sep 2022
Topics: Humans; Meningococcal Infections; Meningococcal Vaccines; Vaccination
PubMed: 36216269
DOI: 10.1055/s-0042-1757755 -
Epidemiology and Infection Jul 2011A literature search traced existing information on meningococcal disease in Asia. Reviewed data describing the epidemiology of meningococcal disease in Asia are... (Review)
Review
A literature search traced existing information on meningococcal disease in Asia. Reviewed data describing the epidemiology of meningococcal disease in Asia are incomplete, due in part to absence of surveillance in many countries, poor bacterial detection methods and social and healthcare barriers to disease reporting. This suggests that meningococcal disease in some Asian countries may be under-recognized, with a need to introduce/improve existing surveillance and case identification systems. Nevertheless, in some developing Asian countries, the disease burden may be significant. Serogroup A meningococcal epidemics are responsible for high morbidity and mortality in some countries and continue to be an ongoing threat, particularly in developing countries. There is an increasing role played by serogroups C, Y, and W-135 in invasive disease, indicating evolving meningococcal disease epidemiology in some countries. Multivalent meningococcal conjugate vaccines offer new opportunities in the region for reducing the meningococcal disease burden.
Topics: Asia; Cost of Illness; Humans; Meningococcal Infections; Population Surveillance
PubMed: 21492496
DOI: 10.1017/S0950268811000574 -
Frontiers in Cellular and Infection... 2023(Nm) is the cause of epidemic meningitis and fulminant meningococcal septicemia. The clinical presentations and outcome of meningococcal septic shock is closely related...
BACKGROUND
(Nm) is the cause of epidemic meningitis and fulminant meningococcal septicemia. The clinical presentations and outcome of meningococcal septic shock is closely related to the circulating levels of lipopolysaccharides (LPS) and of DNA (Nm DNA). We have previously explored the distribution of Nm DNA in tissues from large organs of patients dying of meningococcal septic shock and in a porcine meningococcal septic shock model.
OBJECTIVE
1) To explore the feasibility of measuring LPS levels in tissues from the large organs in patients with meningococcal septic shock and in a porcine meningococcal septic shock model. 2) To evaluate the extent of contamination of non-specific LPS during the preparation of tissue samples.
PATIENTS AND METHODS
Plasma, serum, and fresh frozen (FF) tissue samples from the large organs of three patients with lethal meningococcal septic shock and two patients with lethal pneumococcal disease. Samples from a porcine meningococcal septic shock model were included. Frozen tissue samples were thawed, homogenized, and prepared for quantification of LPS by Pyrochrome Limulus Amoebocyte Lysate (LAL) assay.
RESULTS
DNA and LPS was detected in FF tissue samples from large organs in all patients with meningococcal septic shock. The lungs are the organs with the highest LPS and Nm DNA concentration followed by the heart in two of the three meningococcal shock patients. Nm DNA was not detected in any plasma or tissue sample from patients with lethal pneumococcal infection. LPS was detected at a low level in all FF tissues from the two patients with lethal pneumococcal disease. The experimental porcine meningococcal septic shock model indicates that also in porcinis the highest LPS and Nm DNA concentration are detected in lungs tissue samples. The quantification analysis showed that the highest concentration of both Nm DNA and LPS are in the organs and not in the circulation of patients with lethal meningococcal septic shock. This was also shown in the experimental porcine meningococcal septic shock model.
CONCLUSION
Our results suggest that LPS can be quantified in mammalian tissues by using the LAL assay.
Topics: Animals; Humans; DNA; Lipopolysaccharides; Mammals; Meningitis, Meningococcal; Meningococcal Infections; Neisseria meningitidis; Pneumococcal Infections; Sepsis; Shock, Septic; Swine
PubMed: 38089821
DOI: 10.3389/fcimb.2023.1298360 -
The Lancet. Infectious Diseases May 2021The incidence of invasive meningococcal disease in the UK decreased by approximately four times from 1999 to 2014, with reductions in serogroup C and serogroup B...
BACKGROUND
The incidence of invasive meningococcal disease in the UK decreased by approximately four times from 1999 to 2014, with reductions in serogroup C and serogroup B disease. Lower serogroup C invasive meningococcal disease incidence was attributable to implementation of the meningococcal serogroup C conjugate vaccine in 1999, through direct and indirect protection, but no vaccine was implemented against serogroup B disease. UK Meningococcal Carriage surveys 1-3 (UKMenCar1-3), conducted in 1999, 2000, and 2001, were essential for understanding the impact of vaccination. To investigate the decline in invasive meningococcal disease incidence, we did a large oropharyngeal carriage survey in 2014-15, immediately before the changes to meningococcal vaccines in the UK national immunisation schedule.
METHODS
UKMenCar4 was a cross-sectional survey in adolescents aged 15-19 years who were enrolled from schools and colleges geographically local to one of 11 UK sampling centres between Sept 1, 2014, and March 30, 2015. Participants provided an oropharyngeal swab sample and completed a questionnaire on risk factors for carriage, including social behaviours. Samples were cultured for putative Neisseria spp, which were characterised with serogrouping and whole-genome sequencing. Data from this study were compared with the results from the UKMenCar1-3 surveys (1999-2001).
FINDINGS
From the 19 641 participants (11 332 female, 8242 male, 67 not stated) in UKMenCar4 with culturable swabs and completed risk-factor questionnaires, 1420 meningococci were isolated, with a carriage prevalence of 7·23% (95% CI 6·88-7·60). Carriage prevalence was substantially lower in UKMenCar4 than in the previous surveys: carriage prevalence was 16·6% (95% CI 15·89-17·22; 2306/13 901) in UKMenCar1 (1999), 17·6% (17·05-18·22; 2873/16 295) in UKMenCar2 (2000), and 18·7% (18·12-19·27; 3283/17 569) in UKMenCar3 (2001). Carriage prevalence was lower for all serogroups in UKMenCar4 than in UKMenCar1-3, except for serogroup Y, which was unchanged. The prevalence of carriage-promoting social behaviours decreased from 1999 to 2014-15, with individuals reporting regular cigarette smoking decreasing from 2932 (21·5%) of 13 650 to 2202 (11·2%) of 19 641, kissing in the past week from 6127 (44·8%) of 13 679 to 7320 (37·3%) of 19 641, and attendance at pubs and nightclubs in the past week from 8436 (62·1%) of 13 594 to 7662 (39·0%) of 19 641 (all p<0·0001).
INTERPRETATION
We show that meningococcal carriage prevalence in adolescents sampled nationally during a low incidence period (2014-15) was less than half of that in an equivalent population during a high incidence period (1999-2001). Disease and carriage caused by serogroup C was well controlled by ongoing vaccination. The prevalence of behaviours associated with carriage declined, suggesting that public health policies aimed at influencing behaviour might have further reduced disease.
FUNDING
Wellcome Trust, UK Department of Health, and National Institute for Health Research.
Topics: Adolescent; Carrier State; Cross-Sectional Studies; Female; Humans; Incidence; Male; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Neisseria meningitidis, Serogroup C; Prevalence; Risk Factors; Serogroup; United Kingdom; Vaccination; Young Adult
PubMed: 33482143
DOI: 10.1016/S1473-3099(20)30842-2