INVASIVE MENINGOCOCCAL DISEASE IN ONE YEAR OLDS ELIGIBLE FOR THREE DOSES OF THE NOVEL, MULTICOMPONENT GROUP B MENINGOCOCCAL VACCINE (4CMENB) IN ENGLAND

SUMMARYInvasive meningococcal disease (IMD) reported to the Massachusetts Department of Public Health from 1988 to 2011 was reviewed. The average annual incidence of IMD/100 000 decreased from 1·57 [95% confidence interval (CI) 1·42–1·73] for 1988–1991 to 0·22 (95% CI 0·17–0·29) for 2008–2011. The pattern of decreasing incidence over time differed by age group. There was a decrease in IMD/100 000 in the 0–4 years age group after 1991 from 10·92 (95% CI 8·08–14·70) in 1991 to 5·76 (95% CI 3·78–8·72) in 1992. Incidence in the 0–4 years age group remained below 5/100 000 per year on average thereafter. A substantial reduction in incidence in all age groups was observed between 2000 and 2009, which began before the introduction of conjugate meningococcal vaccine in 2005. Marked reductions in incidence of IMD in Massachusetts, and elsewhere, deserve further investigation with respect to potential factors that go beyond the introduction and deployment of improved meningococcal vaccines.

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Potential Capsule Switching from Serogroup Y to B: The Characterization of Three suchNeisseria meningitidisIsolates Causing Invasive Meningococcal Disease in Canada

Canadian Journal of Infectious Diseases and Medical Microbiology ◽

10.1155/2005/216369 ◽

2005 ◽

Vol 16 (3) ◽

pp. 171-174 ◽

Cited By ~ 15

Author(s):

Raymond SW Tsang ◽

Dennis KS Law ◽

Shaun D Tyler ◽

Gwen S Stephens ◽

Mark Bigham ◽

...

Keyword(s):

Neisseria Meningitidis ◽

Meningococcal Disease ◽

Multilocus Sequence Typing ◽

Housekeeping Gene ◽

Sequence Type ◽

Invasive Meningococcal Disease ◽

Group B

Three group BNeisseria meningitidisisolates, recovered from meningococcal disease cases in Canada and typed as B:2c:P1.5, were characterized. Multilocus sequence typing showed that all three isolates were related because of an identical sequence type (ST) 573. Isolates typed as 2c:P1.5 are common in serogroup Y meningococci but rare in isolates from serogroups B or C. Although no serogroup Y isolates have been typed as ST-573, eight isolates showed five to six housekeeping gene alleles that were identical to that of ST-573. This suggested that the B:2c:P1.5 isolates may have originated from serogroup Y organisms, possibly by capsule switching.

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Invasive meningococcal disease in children in Ireland, 2001–2011

Archives of Disease in Childhood ◽

10.1136/archdischild-2015-310215 ◽

2016 ◽

Vol 101 (12) ◽

pp. 1125-1129 ◽

Cited By ~ 12

Author(s):

Cilian Ó Maoldomhnaigh ◽

Richard J Drew ◽

Patrick Gavin ◽

Mary Cafferkey ◽

Karina M Butler

Keyword(s):

Meningococcal Disease ◽

Clinical Presentation ◽

Assessment Tool ◽

Vaccination Campaign ◽

Invasive Meningococcal Disease ◽

Historical Cohort ◽

Vaccine Introduction ◽

Group B ◽

Study Hospital ◽

Paediatric Intensive Care Units

BackgroundIn 1999, invasive meningococcal disease was hyperendemic in Ireland at 14.75/100 000 population, with 60% group B and 30% group C diseases. National sepsis guidelines and meningococcal C vaccines were introduced in 2000. Despite a spontaneous decline in group B infection, invasive meningococcal disease remains a leading cause of sepsis. This study characterises the epidemiology of invasive meningococcal disease in children in Ireland since the introduction of meningococcal C vaccine and reviews its clinical presentation, hospital course and outcome in anticipation of meningococcal B vaccine introduction.MethodsNational surveillance data were obtained from the Health Protection Surveillance Centre. A retrospective study of all meningococcal cases at two tertiary paediatric hospitals was conducted from 2001 to 2011. Records were reviewed using a standardised assessment tool. A study of 407 meningococcal cases published in 2002 provided comparative data.ResultsOf 1820 cases <19 years of age notified nationally, 382 (21%) cases attended a study hospital; 94% group B, 3% group C, 225 (59%) male, median age 5 years (range 0.1–18). Fever was absent at presentation in 18%. Fifteen patients (3.6%) died. 221 (61%) were admitted to paediatric intensive care units (PICU). Permanent sequelae occurred in 9.4%. Compared with the historical cohort, there were differences in presentation, an increase in PICU interventions, but no significant decline in morbidity or mortality.ConclusionsDespite the meningococcal C vaccination campaign, invasive meningococcal disease continues to cause serious morbidity and claim lives. Group B infections remain dominant. As children who die often present with fulminant disease, preventive strategies including use of meningococcal B vaccine are needed to avert death and sequelae.

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Invasive Meningococcal Disease in Scotland, 1994 to 1999, with Emphasis on Group B Meningococcal Disease

Journal of Clinical Microbiology ◽

10.1128/jcm.40.5.1834-1837.2002 ◽

2002 ◽

Vol 40 (5) ◽

pp. 1834-1837 ◽

Cited By ~ 4

Author(s):

M. H. Kyaw ◽

S. C. Clarke ◽

P. Christie ◽

I. G. Jones ◽

H. Campbell

Keyword(s):

Meningococcal Disease ◽

Invasive Meningococcal Disease ◽

Group B

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Effectiveness of meningococcal vaccines at reducing invasive meningococcal disease and pharyngeal Neisseria meningitidis carriage: A systematic review and meta-analysis

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1733 ◽

2020 ◽

Author(s):

Mark McMillan ◽

Abira Chandrakumar ◽

Hua Lin Rachael Wang ◽

Michelle Clarke ◽

Thomas R Sullivan ◽

...

Keyword(s):

Neisseria Meningitidis ◽

Meningococcal Disease ◽

Incidence Rate Ratio ◽

Meta Analysis ◽

Membrane Vesicle ◽

Invasive Meningococcal Disease ◽

Meningococcal Vaccines ◽

Unpublished Studies ◽

Group B ◽

4Cmenb Vaccine

Abstract Background Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, leads to significant morbidity and mortality worldwide. This review aimed to establish the effectiveness of meningococcal vaccines at preventing IMD and N. meningitidis pharyngeal carriage. Methods A search within PubMed, Embase, Scopus, and unpublished studies up to 1st February 2020 was conducted. Results After removal of duplicates, 8565 were screened and 28 studies included. Protection was provided by meningococcal C vaccines for group C IMD (odds ratio (OR) 0·13 [95% CI, 0·07-0·23]), outer membrane vesicle (OMV) vaccines against group B IMD (OR 0·35 [0·25-0·48]), and meningococcal ACWY (MenACWY) vaccines against group ACWY IMD (OR 0·31 [0·20-0·49]). A single time series analysis found a reduction following an infant 4CMenB program (incidence rate ratio, 0·25 [0·19-0·36]). Multivalent MenACWY vaccines did not reduce carriage (relative risk [RR] 0·88 [0·66-1·18]), unlike monovalent A (RR 0·73 [0·61-0·85]), and C vaccines (RR 0·50 [0·26-0·97]). 4CMenB vaccine had no effect on group B carriage (RR 1·12 [0·90-1·40]). There was also no reduction in group B carriage following MenB-FHbp vaccination (RR 0.98 [0.53-1.79]). Conclusions Meningococcal conjugate C, ACWY, and OMV vaccines are effective at reducing IMD. A small number of studies demonstrate that monovalent C and A conjugate vaccines reduce pharyngeal N. meningitidis carriage. There is no evidence of carriage reduction for multivalent MenACWY, OMV, or recombinant meningococcal B vaccines, which has implications for immunisation strategies. Registration PROSPERO CRD42018082085

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