Meningococcal Disease in Children in Merseyside, England: A 31 Year Descriptive Study

Stanton, Michelle C.; Taylor‐Robinson, David; Harris, David R.; Paize, Fauzia; Makwana, Nick; Hackett, Scott; Baines, Paul; Riordan, F. A. I.; Marzouk, O.; Thomson, A. P. J.; Diggle, Peter J.; Carrol, Enitan D.

doi:10.1371/journal.pone.0025957

Cited by 15 publications

(9 citation statements)

References 18 publications

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“…In a 31-year descriptive study, Stanton et al characterized the cases of meningococcal disease admitted to a tertiary children center in England and identified a significant proportion of cases caused by MenB with the majority of cases occurring below 4 years of age. In this study, the proportion of cases due to MenC increased significantly until the year 2000, when meningococcal vaccination reduced the number of cases to very low levels [16].…”

Section: Discussionmentioning

confidence: 56%

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Bacterial Meningitis in Brazil: Baseline Epidemiologic Assessment of the Decade Prior to the Introduction of Pneumococcal and Meningococcal Vaccines

2013

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BackgroundBacterial meningitis is associated with significant burden in Brazil. In 2010, both 10-valent pneumococcal conjugate vaccine and meningococcal capsular group C conjugate vaccine were introduced into the routine vaccination schedule. Haemophilus influenzae type b vaccine was previously introduced in 1999. This study presents trends in demographics, microbiological characteristics and seasonality patterns of bacterial meningitis cases in Brazil from 2000 to 2010.Methods and FindingsAll meningitis cases confirmed by clinical and/or laboratory criteria notified to the national information system for notifiable diseases between 2000 and 2010 were analyzed. Proportions of bacterial meningitis cases by demographic characteristics, criteria used for confirmation and etiology were calculated. We estimated disease rates per 100,000 population and trends for the study period, with emphasis on H. influenzae, N. meningitidis and S. pneumoniae cases. In the decade, 341,805 cases of meningitis were notified in Brazil. Of the 251,853 cases with defined etiology, 110,264 (43.8%) were due to bacterial meningitis (excluding tuberculosis). Of these, 34,997 (31.7%) were due to meningococcal disease. The incidence of bacterial meningitis significantly decreased from 3.1/100,000 population in 2000–2002 to 2.14/100,000 in 2009–2010 (p<0.01). Among cases of meningococcal disease, the proportion of those associated with group C increased from 41% in 2007 to 61.7% in 2010, while the proportion of group B disease progressively declined. Throughout the study period, an increased number of cases occurred during winter.ConclusionsDespite the reduction in bacterial meningitis incidence during the last decade, it remains a significant healthcare issue in Brazil. Meningococcal disease is responsible for the majority of the cases with group C the most common capsular type. Our study demonstrates the appropriateness of introduction of meningococcal vaccination in Brazil. Furthermore, this study provides a baseline for future evaluation of the impact of the vaccines introduction in Brazil and changes in disease epidemiology.

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Section: Discussionmentioning

confidence: 56%

“…In 2005, the quadrivalent meningococcal conjugate vaccine was licensed for use in adolescents and adults in the USA. Large scale MenC-V vaccination has drastically reduced the incidence of MenC-disease in several countries [13], [16], [27].…”

Section: Discussionmentioning

confidence: 99%

Bacterial Meningitis in Brazil: Baseline Epidemiologic Assessment of the Decade Prior to the Introduction of Pneumococcal and Meningococcal Vaccines

2013

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“…Neisseria meningitidis is feared among health care personnel and lay people owing to its propensity to cause acute meningitis and fulminant septicemia, often in clusters of the population Rosenstein et al, 2001;Stephens et al, 2007). The case fatality rate of systemic meningococcal disease (SMD) has remained fairly stable around 10% since the introduction of sulfa therapy in the 1930s and penicillin in the 1940s (Barquet et al, 1999;Brooks et al, 2006;Stanton et al, 2011;Stoof et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Extensive Changes in Transcriptomic “Fingerprints” and Immunological Cells in the Large Organs of Patients Dying of Acute Septic Shock and Multiple Organ Failure Caused by Neisseria meningitidis

Brusletto

Løberg

Hellerud

et al. 2020

Front. Cell. Infect. Microbiol.

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Background: Patients developing meningococcal septic shock reveal levels of Neisseria meningitidis (10 6-10 8 /mL) and endotoxin (10 1-10 3 EU/mL) in the circulation and organs, leading to acute cardiovascular, pulmonary and renal failure, coagulopathy and a high case fatality rate within 24 h. Objective: To investigate transcriptional profiles in heart, lungs, kidneys, liver, and spleen and immunostain key inflammatory cells and proteins in post mortem formalin-fixed, paraffin-embedded (FFPE) tissue samples from meningococcal septic shock patients. Patients and Methods: Total RNA was isolated from FFPE and fresh frozen (FF) tissue samples from five patients and two controls (acute non-infectious death). Differential expression of genes was detected using Affymetrix microarray analysis. Lung and heart tissue samples were immunostained for T-and B cells, macrophages, neutrophils and the inflammatory markers PAI-1 and MCP-1. Inflammatory mediators were quantified in lysates from FF tissues. Results: The transcriptional profiles showed a complex pattern of protein-coding and non-coding RNAs with significant regulation of pathways associated with organismal death, cell death and survival, leukocyte migration, cellular movement, proliferation of cells, cell-to-cell signaling, immune cell trafficking, and inflammatory responses in an organ-specific clustering manner. The canonical pathways including acute phase response-, EIF2-, TREM1-, IL-6-, HMBG1-, PPAR signaling, and LXR/RXR activation were associated with acute heart, pulmonary, and renal failure. Fewer genes were regulated in the liver and particularly in the spleen. The main upstream regulators were TNF, IL-1β, IL-6, RICTOR, miR-6739-3p, and CD3. Increased numbers of inflammatory cells (CD68+, MPO+, CD3+, and CD20+) were found in lungs and heart. PAI-1 inhibiting Brusletto et al. Transcriptional Profiles in MSS Organs fibrinolysis and MCP-1 attracting leukocyte were found significantly present in the septic tissue samples compared to the controls. Conclusions: FFPE tissue samples can be suitable for gene expression studies as well as immunostaining of specific cells or molecules. The most pronounced gene expression patterns were found in the organs with highest levels of Neisseria meningitidis DNA. Thousands of protein-coding and non-coding RNA transcripts were altered in lungs, heart and kidneys. We identified specific biomarker panels both protein-coding and non-coding RNA transcripts, which differed from organ to organ. Involvement of many genes and pathways add up and the combined effect induce organ failure.

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“…A total of 30 studies reported impact of MCCV vaccination programs and 17 studies reported vaccine effectiveness (direct effect) of MCCV. Studies came from 9 different countries; 11 from England and Wales/UK [20][21][22][23][24][25][26][27][28][29][30], 10 from Spain [31][32][33][34][35][36][37][38][39][40], 5 from Canada [41][42][43][44][45], 4 each from Brazil [46][47][48][49] and Italy [50][51][52][53], 2 each from Australia [54,55] and the Netherlands [56,57], and one each from Germany [58] and Belgium [59]. The MCCV were introduced as part of the routine childhood NIP in all these countries.…”

Section: Resultsmentioning

confidence: 99%

“…There were 6 studies evaluating the impact of the program. Four out of six studies represented earlier post-MCCV periods before 2003 [20][21][22][23] and 2 studies covered later periods between 2006 and 2013 [24,25]. No studies following the 2013 schedule change were available/included in the analysis.…”

Section: United Kingdommentioning

confidence: 99%

Systematic literature review of the impact and effectiveness of monovalent meningococcal C conjugated vaccines when used in routine immunization programs

Htar

Jackson²,

Balmer

et al. 2020

BMC Public Health

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Background Monovalent meningococcal C conjugate vaccine (MCCV) was introduced into the routine immunization program in many countries in Europe and worldwide following the emergence of meningococcal serogroup C (MenC) in the late 1990s. This systematic literature review summarizes the immediate and long-term impact and effectiveness of the different MCCV vaccination schedules and strategies employed. Methods We conducted a systematic literature search for peer-reviewed, scientific publications in the databases of MEDLINE (via PubMed), LILACS, and SCIELO. We included studies from countries where MCCV have been introduced in routine vaccination programs and studies providing the impact and effectiveness of MCCV published between 1st January 2001 and 31st October 2017. Results Forty studies were included in the review; 30 studies reporting impact and 17 reporting effectiveness covering 9 countries (UK, Spain, Italy, Canada, Brazil, Australia, Belgium, Germany and the Netherlands). Following MCCV introduction, significant and immediate reduction of MenC incidence was consistently observed in vaccine eligible ages in all countries with high vaccine uptake. The reduction in non-vaccine eligible ages (especially population > 65 years) through herd protection was generally observed 3–4 years following introduction. Vaccine effectiveness (VE) was mostly assessed through screening methods and ranged from 38 to 100%. The VE was generally highest during the first year after vaccination and waned over time. The VE was better maintained in countries employing catch-up campaigns in older children and adolescents, compared to routine infant only schedules. Conclusions MCCV were highly effective, showing a substantial and sustained decrease in MenC invasive meningococcal disease. The epidemiology of meningococcal disease is in constant transition, and some vaccination programs now include adolescents and higher valent vaccines due to the recent increase in cases caused by serogroups not covered by MCCV. Continuous monitoring of meningococcal disease is essential to understand disease evolution in the setting of different vaccination programs.

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Meningococcal Disease in Children in Merseyside, England: A 31 Year Descriptive Study

Cited by 15 publications

References 18 publications

Bacterial Meningitis in Brazil: Baseline Epidemiologic Assessment of the Decade Prior to the Introduction of Pneumococcal and Meningococcal Vaccines

Bacterial Meningitis in Brazil: Baseline Epidemiologic Assessment of the Decade Prior to the Introduction of Pneumococcal and Meningococcal Vaccines

Extensive Changes in Transcriptomic “Fingerprints” and Immunological Cells in the Large Organs of Patients Dying of Acute Septic Shock and Multiple Organ Failure Caused by Neisseria meningitidis

Systematic literature review of the impact and effectiveness of monovalent meningococcal C conjugated vaccines when used in routine immunization programs

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