Mass gatherings: a review of the scope for meningococcal vaccination in the Indian context

Abstract

The risk of meningococcal transmission is increased with crowding and prolonged close proximity between people. There have been numerous invasive meningococcal disease (IMD) outbreaks associated with mass gatherings and other overcrowded situations, including cramped accommodation, such as student and military housing, and refugee camps. In these conditions, IMD outbreaks predominantly affect adolescents and young adults. In this narrative review, we examine the situation in India, where the burden of IMD-related complications is significant but the reported background incidence of IMD is low. However, active surveillance for meningococcal disease is suboptimal and laboratory confirmation of meningococcal strain is near absent, especially in non-outbreak periods. IMD risk factors are prevalent, including frequent mass gatherings and overcrowding combined with a demographically young population. Since overcrowded situations are generally unavoidable, the way forward relies on preventive measures. More widespread meningococcal vaccination and strengthened disease surveillance are likely to be key to this approach.

Effects of vaccination and non-pharmaceutical interventions and their lag times on the COVID-19 pandemic: Comparison of eight countries

“…However, low vaccine coverage and the prevalence of Delta variants jointly contributed to increases in the numbers of daily new cases in South Korea and Japan. The greater population density and more frequent gatherings in India might have facilitated the transmission of COVID-19 [ 37 ]. Although Israel and India have similar population densities and median age ( Table 1 ), they have very large differences in per capita income and availability of hospital beds.…”

Meningococcal Disease Burden in India: A Systematic Review and Meta-Analysis

“…Several risk factors in India such as overcrowding in public transport or shared accommodations, inadequate hygiene facilities, and mass gatherings, such as social functions, sports competitions, or political, religious, or cultural gatherings; increase the risk of rapid transmission of the disease in the country. 68 This can be seen with frequent outbreaks reported in the country at regular intervals. Hence, routine immunization of high-risk groups as well as infants, adults, and adolescents can be an effective measure to prevent disease transmission in India.…”

Meningococcal Disease and Immunization Activities in Hajj and Umrah Pilgrimage: a review

“…Incidence data are limited, with recent and previous focused reviews unable to report formal incidence rates [50][51][52], although an incidence of 13.2 per 100,000 was reported by WHO in 2005 [47]. Surveillance limitations preclude accurate estimations of the burden of IMD in India [50].…”