Changes inNeisseria meningitidisDisease Epidemiology in the United States, 1998–2007: Implications for Prevention of Meningococcal Disease

Abstract

Before the introduction of the quadrivalent meningococcal conjugate vaccine, the incidence of meningococcal disease in the United States decreased to a historic low. However, meningococcal disease still causes a substantial burden of disease among all age groups. Future vaccination strategies may include targeting infants and preventing serogroup B meningococcal disease.

Immunogenicity and safety of investigational vaccine formulations against meningococcal serogroups A, B, C, W, and Y in healthy adolescents

“…1,2 The highest incidence of this disease occurs in infants in their first year of life, but a second peak occurs in adolescents, 3,4 and higher case fatality rates are generally reported in this age group. The vast majority of IMD can be attributed to infection by one of 5 immunologically-distinct serogroups: A, B, C, W and Y.…”

Preclinical evidence for the potential of a bivalent fHBP vaccine to preventNeisseria meningitidisSerogroup C Disease

“…The fhbp subfamily distribution within the serogroup C isolates divided approximately equally between the two subfamilies, 57 subfamily A and 59 subfamily B. In contrast, the subfamily distribution in US serogroup B isolates during these years, weighted to account for the epidemic in Oregon, 9 was 42% subfamily A and 58% subfamily B, 4 and 39% subfamily A and 61% subfamily B in a larger study encompassing the years 2000-2008. 16 Compared to our survey of 1,814 serogroup B isolates in the US and Europe, 4,10 there was more population diversity with respect to fHBP among the US MnC isolates than among the larger MnB collection: 43 unique fHBP variants within the 116 serogroup C isolates compared to 198 different fHBP variants in the larger serogroup B collection.…”

“…The study isolates were examined for surface collected during the years 2000-2001 through USA Active Bacterial Core surveillance (ABCs), which is a population and lab-based surveillance system and supported by Centers for Disease Control and Prevention. 9 The fhbp sequences were analyzed and fHBP surface expression detected on intact bacteria by flow cytometry. In addition, the bactericidal activity of rabbit and monkey immune sera generated with a bivalent fHBP vaccine against a panel of diverse serogroup C clinical isolates was determined.…”

“…Serogroup C capsule expression was measured using the meningococcal serogroup C capsule polysaccharide specific mAb MNC 46-1. system and supported by Centers for Disease Control and Prevention. 9,15 Sequencing. The fhbp gene in the study isolates was amplified and sequenced as previously described by Murphy, et al Sequences were deposited in GenBank under accessions HM807448-HM807480.…”

Cost of acute hospitalization and post-discharge follow-up care for meningococcal disease in the US

“…Second, while our data were drawn from the most recent years available for the NIS, PCD and LifeLink databases, our study likely does not account for the potential impacts of MCV4 on disease incidence and costs in adolescents. However, the rate of incidence decline has not increased post-MCV4, 16 suggesting a limited …”