Consensus recommendation for meningococcal disease prevention in children and adolescents in the Middle East region

Abstract

Facing the availability of the new generation of quadrivalent meningococcal conjugate vaccines (Menveo®, Menactra® and others pending for license) and their recent implementation in Saudi Arabia, experts from 11 countries of the Middle East region met at a "Meningococcal Leadership Forum" (MLF), which took place in May 2010 in Dubai. The participants of the conference discussed the importance of introducing the concept of conjugate vaccines - especially for children and adolescents - and elaborated a consensus recommendation to support healthcare professionals and decision makers with their expertise. In experts' opinion, conjugate vaccines are the best choice for the prevention of meningococcal disease caused by serogroups A, C, W-135 and Y. As quadrivalent meningococcal conjugate vaccines are registered and available in the Middle East region, they should replace plain polysaccharide vaccines and be integrated in pediatric and adolescent vaccination schedules, including infant vaccination concomitantly with basic EPI vaccines when licensed.

Epidemiology of Meningitis in Oman—Implications for Future Surveillance

“…Invasive meningococcal disease, in meningitis or bacteremia form, has a case fatality rate of 8-15% despite antibiotics and this disease also poses the risk of long term neurological deficits. High risk populations for disease include infants, adolescents, those with asplenia or complement deficiencies, and potentially those with human immunodeficiency virus (HIV) [19,[28][29][30]. Sporadic cases were reported in Oman during the review period of this study.…”

“…The use of conjugate meningococcal vaccines has changed the course of the epidemiology of meningitis globally, regardless of economy; high-and low-income countries have both benefitted from vaccination. Outbreaks at university campuses of serogroup B disease have garnered additional attention to the recent creation of a novel serogroup B vaccine now approved in various countries [29,30]. This also suggests the need for upgrading laboratory facilities for subtyping.…”

Challenges and opportunities for meningococcal vaccination in the developing world

“…[11][12][13] Populations at increased risk for infection include those with impaired immune systems such as infants, young children and the immunocompromised as well as travelers to areas where N. meningitidis is hyperendemic or epidemic and microbiologists who are routinely exposed to isolates of N. meningitidis. 14 Crowded populations such as dormitory students, military recruits, 15 Hajj pilgrims, 16 and oil refineries are also at risk. 17 Carriage rates are low during infancy and peak at 19 years of age with young adults being the most important source of transmission to the community.…”

Consensus recommendation for meningococcal disease prevention for Hajj and Umra pilgrimage/travel medicine

“…A full background and description of transmission, burden of disease and changing pathogenicity as well as a comparison of polysaccharide and conjugate vaccines can be found in the consensus recommendations for prevention of meningococcal disease in children and adolescents that emanated from the Forum [11]. The current report presents the consensus-recommendation for meningococcal quadrivalent (ACWY) conjugate vaccination of pilgrims/ travellers.…”

“…The current report presents the consensus-recommendation for meningococcal quadrivalent (ACWY) conjugate vaccination of pilgrims/ travellers. This manuscript covers parts and extracts of the previously published paediatric consensus paper [11].…”