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

Soumahoro, Lamine; Abitbol, Véronique; Vicic, Nevena; Bekkat-Berkani, Rafik; Sáfadi, Marco Aurélio Palazzi

doi:10.1007/s40121-021-00499-3

Cited by 15 publications

(11 citation statements)

References 128 publications

(168 reference statements)

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“…Emergency vaccination is used to tackle an ongoing epidemic but it is both logistically and financially costly, and preventable deaths may occur while awaiting the onset of vaccine-induced immunity. 53 …”

Section: Discussionmentioning

confidence: 99%

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Review of the epidemiology, diagnosis and management of invasive meningococcal disease in Vietnam

Nguyen

Hưng

Mathur³

et al. 2023

Human Vaccines & Immunotherapeutics

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Invasive meningococcal disease (IMD), caused by Neisseria meningitidis , is life-threatening with a high case fatality rate (CFR) and severe sequelae. We compiled and critically discussed the evidence on IMD epidemiology, antibiotic resistance and disease management in Vietnam, focusing on children. PubMed, Embase and gray literature searches for English, Vietnamese and French publications, with no date restrictions, retrieved 11 eligible studies. IMD incidence rate (/100,000 population) was 7.4 [95% confidence interval 3.6–15.3] in children under 5 years of age; driven by high rates in infants (e.g. 29.1 [8.0–106.0] in 7–11 month-olds). Serogroup B IMD was predominant. Neisseria meningitidis strains may have developed resistance to streptomycin, sulfonamides, ciprofloxacin, and possibly ceftriaxone. There was a lack of current data on diagnosis and treatment of IMD, which remain challenging. Healthcare professionals should be trained to rapidly recognize and treat IMD. Preventive measures, such as routine vaccination, could help address the medical need.

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Section: Discussionmentioning

confidence: 99%

“…Currently, non-vulnerable populations can only obtain these vaccines through the private sector, although routine immunization is the most effective means of controlling IMD. 1 , 53 …”

Section: Discussionmentioning

confidence: 99%

Review of the epidemiology, diagnosis and management of invasive meningococcal disease in Vietnam

Nguyen

Hưng

Mathur³

et al. 2023

Human Vaccines & Immunotherapeutics

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“…During the time period 2012–2019, there were three documented Canadian outbreaks (( 14 )). One outbreak spanned from 2006 to 2013 in the region of Saguenay-Lac-Saint-Jean, Québec, and was due to serogroup B.…”

Section: Discussionmentioning

confidence: 99%

“…A vaccination campaign was launched the following year in the region using the 4CMENB vaccine (( 15 )). The incidence of IMD due to serogroup B fell dramatically in the targeted population of the vaccination campaign (up to 20 years of age) and in 2015, an outbreak was reported in a university in Nova Scotia (( 14 )). The first documented outbreak due to serogroup CC-11 was reported in British Columbia in 2017 and resulted in five cases in adolescents aged 15–19 years (( 14 )).…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of invasive meningococcal disease in Canada, 2012–2019

Saboui¹,

Tsang²,

MacTavish³

et al. 2022

CCDR

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Background A variety of routine childhood and adolescent meningococcal vaccination programs using monovalent (serogroup C) and quadrivalent (A, C, Y, W) conjugate vaccines have been implemented in Canada since 2002, resulting in a decrease in invasive meningococcal disease (IMD) incidence, particularly in serogroup C. Meningococcal vaccines have also been used for outbreak response, including the multicomponent vaccine serogroup B vaccine. This report describes the epidemiology of IMD in Canada from 2012 to 2019. Methods Case data were obtained from the National Enhanced IMD Surveillance System between January 1, 2012 and December 31, 2019. Isolates were sent to the National Microbiology Laboratory for confirmation of serogroup and further studies including phenotype and clonal complex identification. Results A total of 983 cases of IMD were reported between 2012 and 2019. Overall, the age-adjusted incidence of IMD from 2012 to 2019 was 0.34 cases per 100,000 population per year when standardized to the Canadian 2011 population age distribution (95% CI: 0.32–0.36). Infants younger than one year of age had the highest average age-specific incidence rate (3.6 cases per 100,000 population per year, 95% CI: 2.8–4.3). The highest age-adjusted incidence rate was associated with serogroup B (0.17 cases per 100, 000 population per year, 95% CI: 0.16–0.19). Prior to 2015, most invasive serogroup W isolates were identified as clonal complex 22 (ST-22 CC) and the increase in serogroup W in Canada in recent years has been associated with the replacement of the endemic ST-22 CC with the hyper-virulent ST-11 CC. Conclusion Invasive meningococcal disease is a rare but severe infection in Canada that mostly affects the very young. Serogroup B continues to account for the greatest proportion of disease. Serogroup W associated with ST-11 CC is becoming a growing contributor of disease in all age groups not protected by serogroup W-containing vaccines.

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“…Globally, the greatest burden and highest incidence of IMD is in infants and young children, with a second peak in adolescents, 1 , 4 , 5 while more recent epidemiological trends indicate an increased burden in adults and the elderly, where case fatality rates (CFRs) are also higher. 1 , 7 , 13 , 14 Global epidemiology shows substantial geographical variation, both in terms of disease burden and in the relative importance of specific serogroups in local or regional IMD epidemiology, 1 , 4 , 5 with temporal shifts driven by both cyclic epidemiologic patterns, disease outbreaks, 15 and the introduction of effective vaccines against major pathogenic serogroups. Use of conjugated monovalent MenC vaccines, quadrivalent MenACWY vaccines and protein-based vaccines against MenB in national immunization programs (NIPs), mostly targeting infants and adolescents, has led to substantial declines in the IMD burden in these at-risk populations, 1 , 5 , 16 , 17 …”

Section: Introductionmentioning

confidence: 99%

Meningococcal disease within the Gulf Cooperation Council Countries

Awaidy

Ozudogru

Badur³

2023

Human Vaccines & Immunotherapeutics

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This review reports on the recent epidemiology of invasive meningococcal disease (IMD) within the Gulf Cooperation Council (GCC) Countries (focusing from 2012 onwards), the existing immunization strategies and the potential for IMD resurgence. MenACWY vaccination is now established in infant or adolescent immunization programs in Saudi Arabia, Bahrain, Kuwait, and the United Arab Emirates. At present, GCC Countries do not include MenB immunization. National health surveillance reports indicate a total of 156 IMD cases reported across the GCC Countries between 2012 and 2021; between 30% and 80% of cases were reported in individuals aged ≥15 years. Lack of serogroup data hinders the assessment of vaccine impact and decision-making on additional vaccine introductions (e.g. MenB immunization). Hajj/Umrah pilgrimage and the increasing number of large-scale commercial and social events held in the GCC Countries pose a potential risk for future IMD outbreaks. Immunization policies for such events could be strengthened.

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

Abstract: This article is published with digital features, including a graphical plain language summary, to facilitate understanding of the article. To view digital features for this article go to

Cited by 15 publications

References 128 publications

Review of the epidemiology, diagnosis and management of invasive meningococcal disease in Vietnam

Review of the epidemiology, diagnosis and management of invasive meningococcal disease in Vietnam

Epidemiology of invasive meningococcal disease in Canada, 2012–2019

Meningococcal disease within the Gulf Cooperation Council Countries

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