Meningococcal immunisation and protection from epidemics

Hassan, Jacques; Massougbodji, Achille; Chippaux, Jean-Philippe; Massit, Bruno; Josse, R.

doi:10.1016/s0140-6736(05)60508-9

Cited by 13 publications

(8 citation statements)

References 3 publications

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“…It is known that the mothers are ready to mobilize themselves and take part in preventive immunization campaigns and even contribute financially to cost recovery [82]. However, when the strategy is adopted, it will be necessary to define the methods of application which must be both acceptable and relevant and evaluate the potential risk of meningococci serogroup selection.…”

Section: Resultsmentioning

confidence: 99%

“…In contrast to the obvious failure of current strategies [80], the evidence from many epidemiologic studies have indicated that large-scale preventive immunization using MPV may well be effective [4,42]. Large-scale vaccination campaigns with MPV were organized in many Sahel countries, including Niger, Bénin, Egypt and Senegal [32,[81][82][83]. In Senegal, the incidence of meningitis during the epidemic was two times lower in the villages that benefited from largescale vaccination two years before, than in the others [25].…”

Section: Control Of Epidemicsmentioning

confidence: 99%

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Control of meningococcal meningitis outbreaks in sub-Saharan Africa

Chippaux

2008

J Infect Dev Ctries

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Outbreaks of Neisseria meningitidis recur frequently in the African Sahel where they are responsible for high mortality and morbidity, especially in children. An effective vaccine has been in existence for more than 30 years, but despite this, the control of epidemics has failed. Moreover, the geographical distribution of N. meningitidis seems to be increasing, perhaps because of climate change but also because of the economic crisis which prevails throughout much of Africa leading to population movements and the breakdown of essential services. Although alarming, the emergence of new serogroups in recent epidemics (such as serogroups X and W135) should not mask the fact that serogroup A remains the most common meningococcal isolate from meningitis cases and is therefore the most significant target for control. The development of a low-cost conjugate meningococcal vaccine should support a strategy of preventive immunization, as this strategy is one that appears most effective to control this plague.

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Section: Resultsmentioning

confidence: 99%

Section: Control Of Epidemicsmentioning

confidence: 99%

Control of meningococcal meningitis outbreaks in sub-Saharan Africa

Chippaux

2008

J Infect Dev Ctries

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“…During the 1980s, large-scale vaccination campaigns to prevent further epidemic outbreaks were implemented in many countries, notably Niger [13] and Benin [14]. The absence of coordination and the poor organization of these campaigns soon revealed the limits of this strategy.…”

Section: Strategy Optionsmentioning

confidence: 99%

“…This strategy is currently much debated due to its obvious failure [12], as assessed by the high annual incidence of meningococcal meningitis in sub-Saharan countries (Table 1) and the possible effectiveness of preventive mass vaccination with cost recovery [13,14].…”

Section: Introductionmentioning

confidence: 99%

A Critical Review of Control Strategies against Meningococcal Meningitis Epidemics in Sub-Saharan African Countries

2002

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The control strategy of meningitis epidemics in sub-Saharan countries, although reexamined regularly, is based on epidemiological, immunological and logistical considerations put forward at the end of the 1970s. It comprises organizing large-scale vaccinations in the event of a declared epidemic. The obvious failure of this strategy recommended by the World Health Organization (WHO) necessitates evaluation of the emergency vaccination criteria. Despite current controversy on the immunogenicity of the polysaccharide vaccine, its safety, effectiveness in the field and low cost could justify the reopening of a debate on its use in routine vaccination. Routine--or preventive--vaccination could significantly reduce the incidence of meningococcal meningitis and its severity. The conjugate vaccine, when available, will constitute an additional advantage in the prevention of meningococcal meningitis. A strategy combining both polysaccharide and conjugate vaccines according to the population targets and possibilities for funding remain to be defined.

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“…Reports of breakthrough infection a year after the United Kingdom infant schedule (36) have prompted a discussion on the need for booster immunizations, probably in the second year of life but potentially in adolescence or even adulthood. While parenteral serogroup A and C polysaccharide vaccines have brought benefit in some African countries such as Egypt (28) and Benin (16), the problem of cold chain integrity and transmission of blood-borne viruses by parenteral immunization, together with high costs of conjugate vaccines, remains a major challenge to deployment throughout areas where N. meningitidis is highly endemic such as sub-Saharan Africa.…”

mentioning

confidence: 99%

Induction of Protective Serum Meningococcal Bactericidal and Diphtheria-Neutralizing Antibodies and Mucosal Immunoglobulin A in Volunteers by Nasal Insufflations of theNeisseria meningitidisSerogroup C Polysaccharide-CRM197 Conjugate Vaccine Mixed with Chitosan

et al. 2005

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Thirty-six healthy volunteers received either a single intramuscular injection of Neisseria meningitidis serogroup C polysaccharide (MCP)-CRM197 conjugate vaccine in alum or two nasal insufflations 28 days apart of the same vaccine powder, without alum, mixed with chitosan. Nasal immunization was well tolerated, with fewer symptoms reported than after intramuscular injection. The geometric mean concentrations of MCPspecific immunoglobulin G (IgG) after one nasal immunization were 3.25 g/ml in naïve subjects and 14.4 g/ml in subjects previously immunized parenterally, compared with 4.30 g/ml in naïve subjects immunized intramuscularly. The geometric mean titer of serum bactericidal antibody (SBA) rose 24-fold after two nasal immunizations in naïve subjects and was comparable to parenteral immunization (1,080 versus 1,625). All subjects achieved SBA titers associated with protection after two nasal immunizations: even those with titers of <8 at entry. A single nasal immunization boosted the SBA titer to >128 in 96% of previously immunized subjects, and two immunizations achieved this level in 92% of naive subjects. MCP-specific IgG levels were ϳ70% IgG2 and ϳ20% IgG1 after nasal or intramuscular immunization. Increases in CRM197-specific IgG and diphtheria toxin-neutralizing activity were observed after nasal or intramuscular immunization, with balanced IgG1/IgG2 and higher IgG4. Significant MCP-specific secretory IgA was detected in nasal wash only after nasal immunization and predominantly on the immunized side. Simple nasal insufflation of existing MCP-CRM197 conjugate vaccines in chitosan offers an inexpensive but effective needle-free prime and boost against serogroup C N. meningitidis and diphtheria.

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Meningococcal immunisation and protection from epidemics

Cited by 13 publications

References 3 publications

Control of meningococcal meningitis outbreaks in sub-Saharan Africa

Control of meningococcal meningitis outbreaks in sub-Saharan Africa

A Critical Review of Control Strategies against Meningococcal Meningitis Epidemics in Sub-Saharan African Countries

Induction of Protective Serum Meningococcal Bactericidal and Diphtheria-Neutralizing Antibodies and Mucosal Immunoglobulin A in Volunteers by Nasal Insufflations of theNeisseria meningitidisSerogroup C Polysaccharide-CRM197 Conjugate Vaccine Mixed with Chitosan

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