Case Manifestations and Public Health Response for Outbreak of Meningococcal W Disease, Central Australia, 2017

Global Epidemiology of Vaccine-preventable Bacterial Meningitis

“…Early outbreaks of serogroup W meningococcal (MenW) disease were observed following Hajj pilgrimages in 2000 and 2001. 24 Although cases and outbreaks decreased in subsequent years because of mandatory vaccination for pilgrims traveling to the Hajj, they have been increasingly responsible for local epidemics and caused large outbreaks nationally in South Africa, the United Kingdom, Australia and Chile, among other countries. 24 Recently, in the Netherlands, MenW cases also increased, with 52% of MenW meningitis episodes diagnosed during 2015 to 2019 among preschool- and school-aged children.…”

“…24 Although cases and outbreaks decreased in subsequent years because of mandatory vaccination for pilgrims traveling to the Hajj, they have been increasingly responsible for local epidemics and caused large outbreaks nationally in South Africa, the United Kingdom, Australia and Chile, among other countries. 24 Recently, in the Netherlands, MenW cases also increased, with 52% of MenW meningitis episodes diagnosed during 2015 to 2019 among preschool-and school-aged children. 3 In the African meningitis belt during epidemics, mainly caused by serogroup A meningococcal (MenA) disease but also by other serogroups, the incidence was as high as 1% of inhabitants.…”

Meningococcal Disease Outbreaks: A Moving Target and a Case for Routine Preventative Vaccination

“…No patient died and the number of cases of MenW IMD decreased rapidly after the onset of the vaccination campaign. The remoteness of the Central Australian indigenous population and frequent movements between communities were challenges specific to this outbreak that necessitated a different approach compared to outbreaks in urban centres, including the use of a fever protocol and presumptive antibiotic treatment for febrile illnesses [80]. [81].…”

“…The logistics involved with accessing the target population differed in high-versus low-income countries, with apathy, particularly among students and young adults, or reluctance to identify close contacts (recreational drug users) negatively impacting uptake in high/upper-middle-income countries [49,69,77]. Accessing the target population posed specific challenges when they were located in remote settings such as central Australian indigenous communities [80], remote communities in African countries requiring the use of mobile laboratories [87] and in slum areas of large cities where house-by-house vaccination was undertaken [91].…”