scholarly journals Epidemiology of meningococcal meningitis in Angola, 1994–2000

2001 ◽  
Vol 127 (3) ◽  
pp. 421-424 ◽  
Author(s):  
M. GASPAR ◽  
F. LEITE ◽  
L. BRUMANA ◽  
B. FÉLIX ◽  
A. A. STELLA
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Age Groups ◽  
Disease Outbreaks ◽  
Civil Conflict ◽  
Polysaccharide Vaccine ◽  
Meningococcal Meningitis ◽  
Mass Vaccination ◽  
Meningitis Belt ◽  
Vaccination Campaigns

We describe six meningococcal disease outbreaks that occurred in Angola during the period 1994–2000. In total, 7140 cases were documented. The age groups most affected were 15–29 years and 5–14 years; there were no differences in incidence between the sexes. Circulation of both serogroup A and sporadic serogroup B strains was demonstrated. Mass vaccination campaigns with A+C meningococcal polysaccharide vaccine were implemented, except in Yambala province in 1999 where insecure conditions precluded this intervention.Outbreaks of serogroup A meningococcal disease in Angola may indicate an extension of these epidemics outside the meningitis belt. Mass vaccination campaigns stopped the Angolan epidemics within weeks. Civil conflict and displaced persons living in crowded areas created serious difficulties for surveillance and impeded timely public health responses.

scholarly journals Insights on Population Structure and Within-Host Genetic Changes among Meningococcal Carriage Isolates from U.S. Universities

mSphere ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Sandeep J. Joseph ◽  
Nadav Topaz ◽  
How-Yi Chang ◽  
Melissa J. Whaley ◽  
Jeni T. Vuong ◽  
...  
Keyword(s):  
General Population ◽  
Neisseria Meningitidis ◽  
Meningococcal Disease ◽  
Mass Vaccination ◽  
Invasive Meningococcal Disease ◽  
Whole Genome ◽  
Genetic Changes ◽  
Content Type ◽  
Host Genetic ◽  
Vaccination Campaigns

ABSTRACT In 2015 and 2016, meningococcal carriage evaluations were conducted at two universities in the United States following mass vaccination campaigns in response to Neisseria meningitidis serogroup B (NmB) disease outbreaks. A simultaneous carriage evaluation was also conducted at a university near one of the outbreaks, where no NmB cases were reported and no mass vaccination occurred. A total of ten cross-sectional carriage evaluation rounds were conducted, resulting in 1,514 meningococcal carriage isolates collected from 7,001 unique participants; 1,587 individuals were swabbed at multiple time points (repeat participants). All isolates underwent whole-genome sequencing. The most frequently observed clonal complexes (CC) were CC198 (27.3%), followed by CC1157 (17.4%), CC41/44 (9.8%), CC35 (7.4%), and CC32 (5.6%). Phylogenetic analysis identified carriage isolates that were highly similar to the NmB outbreak strains; comparative genomics between these outbreak and carriage isolates revealed genetic changes in virulence genes. Among repeat participants, 348 individuals carried meningococcal bacteria during at least one carriage evaluation round; 50.3% retained N. meningitidis carriage of a strain with the same sequence type (ST) and CC across rounds, 44.3% only carried N. meningitidis in one round, and 5.4% acquired a new N. meningitidis strain between rounds. Recombination, point mutations, deletions, and simple sequence repeats were the most frequent genetic mechanisms found in isolates collected from hosts carrying a strain of the same ST and CC across rounds. Our findings provide insight on the dynamics of meningococcal carriage among a population that is at higher risk for invasive meningococcal disease than the general population. IMPORTANCE U.S. university students are at a higher risk of invasive meningococcal disease than the general population. The responsible pathogen, Neisseria meningitidis, can be carried asymptomatically in the oropharynx; the dynamics of meningococcal carriage and the genetic features that distinguish carriage versus disease states are not completely understood. Through our analyses, we aimed to provide data to address these topics. We whole-genome sequenced 1,514 meningococcal carriage isolates from individuals at three U.S. universities, two of which underwent mass vaccination campaigns following recent meningococcal outbreaks. We describe the within-host genetic changes among individuals carrying a strain with the same molecular type over time, the primary strains being carried in this population, and the genetic differences between closely related outbreak and carriage strains. Our results provide detailed information on the dynamics of meningococcal carriage and the genetic differences in carriage and outbreak strains, which can inform future efforts to reduce the incidence of invasive meningococcal disease.

scholarly journals The Cost and Public Health Burden of Invasive Meningococcal Disease Outbreaks: A Systematic Review

2013 ◽  
Vol 31 (7) ◽  
pp. 563-576 ◽  
Author(s):  
Andrea Anonychuk ◽  
Gloria Woo ◽  
Andrew Vyse ◽  
Nadia Demarteau ◽  
Andrea C. Tricco
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Meningococcal Disease ◽  
Disease Outbreaks ◽  
Invasive Meningococcal Disease ◽  
Public Health Burden ◽  
Health Burden ◽  
The Cost

scholarly journals Acquisition of Meningococcal Serogroup W-135 Carriage in Turkish Hajj Pilgrims Who Had Received the Quadrivalent Meningococcal Polysaccharide Vaccine

2012 ◽  
Vol 20 (1) ◽  
pp. 66-68 ◽  
Author(s):  
M. Ceyhan ◽  
M. Celik ◽  
E. T. Demir ◽  
V. Gurbuz ◽  
A. E. Aycan ◽  
...  
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Health Problem ◽  
Family Members ◽  
Public Health Problem ◽  
Polysaccharide Vaccine ◽  
Invasive Meningococcal Disease ◽  
Household Contacts ◽  
To Receive ◽  
Close Contacts

ABSTRACTInvasive meningococcal disease is a recognized public health problem worldwide, with a dynamic and changeable epidemiology. In Turkey, the second most common pathogenic meningococcal serogroup (after serogroup B) is W-135, including an epidemic in 2005, which has been strongly associated with Hajj pilgrims and their close contacts. In two studies conducted in 2010, we assessed meningococcal carriage in intending Turkish pilgrims to the Hajj when they attended to receive a plain polysaccharide vaccine against serogroups A, C, W-135, and Y and, upon their return, to determine the acquisition of meningococcal carriage by the pilgrims themselves and subsequently their household contacts. Nasopharyngeal swabs were obtained from pilgrims before the Hajj and upon their return. Swabs were then obtained from 39 household contacts of pilgrims who were shown to have acquired carriage during the Hajj. Of the 472 pilgrims before the Hajj, 63 (13%) were positive for meningococcal carriage, of which 52 cases (83%) were serogroup W-135. In the 296 pilgrims tested after the Hajj, 81 (27%) were positive for meningococcal carriage, including 74 (91%) with W-135. In 11 family members of pilgrims who acquired W-135 carriage at the Hajj, 10 (91%) had acquired carriage of serogroup W-135. This study illustrates the acquisition of meningococcal carriage, predominantly of serogroup W-135 by pilgrims attending the Hajj, and the transmission of this carriage to their family members on their return, explaining the source of W-135 meningococcal disease in Turkey.

scholarly journals Seasonal upsurge of pneumococcal meningitis in the Central African Republic

2019 ◽  
Vol 3 ◽  
pp. 134
Author(s):  
Thomas Crellen ◽  
V. Bhargavi Rao ◽  
Turid Piening ◽  
Joke Zeydner ◽  
M. Ruby Siddiqui
Keyword(s):  
Bacterial Meningitis ◽  
Pneumococcal Meningitis ◽  
Central African Republic ◽  
Vaccine Coverage ◽  
Case Fatality ◽  
Dry Season ◽  
Meningococcal Meningitis ◽  
Meningitis Belt ◽  
Lower Case ◽  
Vaccination Campaigns

A high incidence of bacterial meningitis was observed in the Central African Republic (CAR) from December 2015 to May 2017 in three hospitals in the northwest of the country that are within the African meningitis belt. The majority of cases were caused by Streptococcus pneumoniae (249/328; 75.9%), which occurred disproportionately during the dry season (November-April) with a high case-fatality ratio of 41.6% (95% confidence interval [CI] 33.0, 50.8%). High rates of bacterial meningitis during the dry season in the meningitis belt have typically been caused by Neisseria meningitidis (meningococcal meningitis), and our observations suggest that the risk of contracting S. pneumoniae (pneumococcal) meningitis is increased by the same environmental factors. Cases of meningococcal meningitis (67/328; 20.4%) observed over the same period were predominantly group W and had a lower case fatality rate of 9.6% (95% CI 3.6, 21.8%). Due to conflict and difficulties in accessing medical facilities, it is likely that the reported cases represented only a small proportion of the overall burden. Nationwide vaccination campaigns in the CAR against meningitis have been limited to the use of MenAfriVac, which targets only meningococcal meningitis group A. We therefore highlight the need for expanded vaccine coverage to prevent additional causes of seasonal outbreaks.

scholarly journals Impact of MenAfriVac on Meningococcal A Meningitis in Cameroon: A Retrospective Study Using Case-by-Case-Based Surveillance Data from 2009 to 2015

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Bouba Gake ◽  
Bonaventure Babinne Graobe ◽  
Bouba Abdouraman ◽  
Crescence Satou Ngah ◽  
Ahmadou Aissatou ◽  
...  
Keyword(s):  
Public Health ◽  
Immunization Coverage ◽  
Mass Vaccination ◽  
Health Concern ◽  
Meningitis Belt ◽  
Lack Of Information ◽  
Before And After ◽  
The Impact ◽  
Regional Public Health ◽  
Case Based

Meningococcal meningitis is a public health concern in Africa. Conjugated vaccine against serogroup A Neisseria meningitidis (MenAfriVac) was used in mass vaccination and was proved to have a good impact in the meningitis belt. There is a lack of information about the impact of this intervention in Cameroon after mass vaccination was undertaken. This study aimed at filling the gap in its unknown impact in Cameroon. A retrospective longitudinal study using biological monitoring data of case-by-case-based surveillance for meningitis was obtained from the National Reference Laboratories from 1 January 2009 to 20 September 2015. Immunization coverage data were obtained from Regional Public Health Delegations where immunizations took place. We compared the risks of vaccine serogroup occurrence before and after vaccinations and calculated the global impact using Halloran’s formula. Annual cases of meningitis A decreased gradually from 92 in 2011 to 34 in 2012 and then to 1 case in 2013, and since 2014, no cases have been detected. The impact was estimated at 14.48% ( p = 0.41 ) in 2012 and then at 98.63% ( p < 0.0001 ) after the end of vaccinations in 2013. This survey confirms the effectiveness of the MenAfriVac vaccine in Cameroon as expected by the WHO. The surveillance must be pursued and enhanced to monitor coming immunizations measures with multivalent conjugated vaccines for this changing threat.

scholarly journals Seasonal upsurge of pneumococcal meningitis in the Central African Republic

2018 ◽  
Vol 3 ◽  
pp. 134 ◽  
Author(s):  
Thomas Crellen ◽  
V. Bhargavi Rao ◽  
Turid Piening ◽  
Joke Zeydner ◽  
M. Ruby Siddiqui
Keyword(s):  
Bacterial Meningitis ◽  
Pneumococcal Meningitis ◽  
Central African Republic ◽  
Vaccine Coverage ◽  
Case Fatality ◽  
Dry Season ◽  
Meningococcal Meningitis ◽  
Meningitis Belt ◽  
Lower Case ◽  
Vaccination Campaigns

A high incidence of bacterial meningitis was observed in the Central African Republic (CAR) from December 2015 to May 2017 in three hospitals in the northwest of the country that are within the African meningitis belt. The majority of cases were caused by Streptococcus pneumoniae (249/328; 75.9%), which occurred disproportionately during the dry season (November-April) with a high case-fatality ratio of 41.6% (95% confidence interval [CI] 33.0, 50.8%). High rates of bacterial meningitis during the dry season in the meningitis belt are typically caused by Neisseria meningitidis (meningococcal meningitis), and our observations suggest that the risk of contracting S. pneumoniae (pneumococcal) meningitis is increased by the same environmental factors. Cases of meningococcal meningitis (67/328; 20.4%) observed over the same period were predominantly type W and had a lower case fatality rate of 9.6% (95% CI 3.6, 21.8%). Due to conflict and difficulties in accessing medical facilities, it is likely that the reported cases represented only a small proportion of the overall burden and that there is high underlying prevalence of S. pneumoniae carriage in the community. Nationwide vaccination campaigns in the CAR against meningitis have been limited to the use of MenAfriVac, which targets only meningococcal meningitis type A. We therefore highlight the need for expanded vaccine coverage to prevent additional causes of seasonal outbreaks.

scholarly journals Effectiveness of Mass Vaccination in Brazil against Severe COVID-19 Cases

2021 ◽  
Author(s):  
Daniel A.M. Villela ◽  
Tatiana Guimarães de Noronha ◽  
Leonardo S Bastos ◽  
Antonio G. F. Pacheco ◽  
Oswaldo G. Cruz ◽  
...  
Keyword(s):  
Age Groups ◽  
Vaccine Effectiveness ◽  
Mass Vaccination ◽  
Vulnerable Groups ◽  
Age Group ◽  
Vaccine Platform ◽  
National Immunization ◽  
Younger Age ◽  
National Cohort ◽  
Vaccination Campaigns

Background. Mass vaccination campaigns started in Brazil on January/2021 with CoronaVac followed by ChAdOx1 nCov-19, and BNT162b2 mRNA vaccines. Target populations initially included vulnerable groups such as people older than 80 years, with comorbidities, of indigenous origin, and healthcare workers. Younger age groups were gradually included. Methods. A national cohort of 66.3 million records was compiled by linking registry-certified COVID-19 vaccination records from the Brazilian National Immunization Program with information on severe COVID-19 cases and deaths. Cases and deaths were aggregated by state and age group. Mixed-effects Poisson models were used to estimate the rate of severe cases and deaths among vaccinated and unvaccinated individuals, and the corresponding estimates of vaccine effectiveness by vaccine platform and age group. The study period is from mid-January to mid-July 2021. Results. Estimates of vaccine effectiveness preventing deaths were highest at 97.9% (95% CrI: 93.5-99.8) among 20-39 years old with ChAdOx1 nCov-19, at 82.7% (95% CrI: 80.7-84.6) among 40-59 years old with CoronaVac, and at 89.9% (87.8--91.8) among 40-59 years old with partial immunization of BNT162b2. For all vaccines combined in the full regimen, the effectiveness preventing severe cases among individuals aged 80+ years old was 35.9% (95% CrI: 34.9-36.9) which is lower than that observed for individuals aged 60-79 years (61.0%, 95% CrI: 60.5-61.5). Conclusion. Despite varying effectiveness estimates, Brazil′s population benefited from vaccination in preventing severe COVID-19 outcomes. Results, however, suggest significant vaccine-specific reductions in effectiveness by age, given by differences between age groups 60-79 years and over 80 years.

The challenges of influenza for public health

2019 ◽  
Vol 14 (16) ◽  
pp. 1429-1436 ◽  
Author(s):  
Francisco Álvarez ◽  
Filipe Froes ◽  
Amos García Rojas ◽  
David Moreno-Perez ◽  
Federico Martinón-Torres
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Respiratory System ◽  
Age Groups ◽  
Health Impact ◽  
Vaccine Preventable Disease ◽  
Pathogenic Agent ◽  
Expert Meeting ◽  
Life Threatening ◽  
Vaccination Campaigns

Influenza, an infectious disease of the respiratory system, represents a major burden for public health. This disease affects all age groups with different prognosis, being life threatening for vulnerable individuals. Despite influenza being a vaccine-preventable disease, the control of the infection needs annual vaccination campaigns and constant improvements. Herein, the main challenges of influenza in relation to the pathogenic agent, the available vaccines and the health impact identified during the Light on Vax event, an expert meeting organized by the Asociación Española de Vacunología [Spanish Vaccinology Association] (AEV), are reported. Further possible steps in the control of influenza are also suggested. Ideally, the development of innovative and universal vaccines that would confer life-lasting and broader-spectrum immunity is highly desirable.

scholarly journals Analysis of a meningococcal meningitis outbreak in Niger – potential effectiveness of reactive prophylaxis

2018 ◽  
Author(s):  
Matt D.T. Hitchings ◽  
Matthew E Coldiron ◽  
Rebecca F Grais ◽  
Marc Lipsitch
Keyword(s):  
Antibiotic Prophylaxis ◽  
Control Measure ◽  
Vaccination Strategy ◽  
Meningococcal Meningitis ◽  
Mass Vaccination ◽  
Potential Effectiveness ◽  
Village Level ◽  
Meningitis Belt ◽  
Effectiveness And Efficiency ◽  
Reactive Vaccination

Background Seasonal epidemics of bacterial meningitis in the African Meningitis Belt carry a high burden of disease and mortality. Reactive mass vaccination is used as a control measure during epidemics, but the time taken to gain immunity from the vaccine reduces the flexibility and effectiveness of these campaigns. Highly targeted reactive antibiotic propylaxis could be used to supplement reactive mass vaccination and further reduce the incidence of meningitis, and the potential effectiveness and efficiency of these strategies should be explored. Methods and Findings Data from an outbreak of meningococcal meningitis in Niger, caused primarily by Neisseria meningitidis serogroup C, is used to estimate clustering of meningitis cases at the household and village level. In addition, reactive antibiotic prophylaxis and reactive vaccination strategies are simulated to estimate their potential effectiveness and efficiency, with a focus on the threshold and spatial unit used to declare an epidemic and initiate the intervention. There is village-level clustering of meningitis cases after an epidemic has been declared in a health area. Meningitis risk among household contacts of a meningitis case is no higher than among members of the same village. Village-wide antibiotic prophylaxis can target secondary cases in villages: across of range of parameters pertaining to how the intervention is performed, up to 200/ 672 cases during the season are potentially preventable. On the other hand, household prophylaxis targets very few cases. In general, the village-wide strategy is not very sensitive to the method used to declare an epidemic. Finally, village-wide antibiotic prophylaxis is potentially more efficient than mass vaccination of all individuals at the beginning of the season, and than the equivalent reactive vaccination strategy. Conclusions Village-wide antibiotic prophylaxis should be considered and tested further as a response against outbreaks of meningococcal meningitis in the Meningitis Belt, as a supplement to reactive mass vaccination.

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