Meningococcal vaccines: a neglected topic in travel medicine?

Abstract

Meningococcal disease is a devastating disease. Regular epidemics, particularly in the African meningitis belt and outbreaks during the Hajj pilgrimage, have caused significant morbidity and mortality. Although meningococcal vaccination is recommended for travelers to these destinations, disease awareness among travelers is generally poor. Case-fatality rates of meningococcal disease are high (10-14%) and the disease can be fatal within 24 h, even when the best healthcare is available. This is particularly relevant to travelers, as gaining timely and accurate diagnosis and treatment is often difficult in foreign countries or remote regions. Given the unpredictable epidemiology of the disease, broad meningococcal vaccination for all ages should be considered for travelers. Conjugate meningococcal vaccines have significant advantages over polysaccharide vaccines, and should be the preferred option for travelers.

Awareness of Meningococcal Disease among Travelers from the United Kingdom to the Meningitis Belt in Africa

“…Traveler's awareness of the risk of contracting meningococcal disease 13 is low, particularly when compared with their understanding of other travel-related infections, such as malaria and yellow fever, and these findings were confirmed by this study.…”

“…Such low levels of awareness were similar to those described in other studies. 13,14 Lack of knowledge occurred even among those at particular risk of meningococcal infection, such as travelers who are travelers visiting friends and relatives, backpackers, and adolescents (14-25 year old).…”

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

“…Owing to the high morbidity and mortality and the changing epidemiology, vaccination as broad as possible is recommended for prevention of meningococcal infections in travellers, particularly in pilgrims. While the incidence of infection in travellers to developing countries is about 0.5 per 100 000, it can be much higher in Hajj pilgrims (640 per 100 000) and their contacts (up to 28 per 100 000) and peaks during meningitis belt epidemics (up to 800 per 100 000) [13].…”

Role of Factor H Binding Protein in Neisseria meningitidis Virulence and Its Potential as a Vaccine Candidate To Broadly Protect against Meningococcal Disease

“…Disease often progresses very rapidly and is therefore difficult to di-agnose and treat. Disease rates vary from 1 to 1,000 per 100,000 (1,2). The rates of disease are highest among infants, followed by a second peak during adolescence and early adulthood.…”