Global epidemiology of invasive meningococcal disease

Abstract

Neisseria meningitidis is one of the leading causes of bacterial meningitis globally and can also cause sepsis, pneumonia, and other manifestations. In countries with high endemic rates, the disease burden places an immense strain on the public health system. The worldwide epidemiology of invasive meningococcal disease (IMD) varies markedly by region and over time. This review summarizes the burden of IMD in different countries and identifies the highest-incidence countries where routine preventive programs against Neisseria meningitidis would be most beneficial in providing protection. Available epidemiological data from the past 20 years in World Health Organization and European Centre for Disease Prevention and Control collections and published articles are included in this review, as well as direct communications with leading experts in the field. Countries were grouped into high-, moderate-, and low-incidence countries. The majority of countries in the high-incidence group are found in the African meningitis belt; many moderate-incidence countries are found in the European and African regions, and Australia, while low-incidence countries include many from Europe and the Americas. Priority countries for vaccine intervention are high- and moderate-incidence countries where vaccine-preventable serogroups predominate. Epidemiological data on burden of IMD are needed in countries where this is not known, particularly in South- East Asia and Eastern Mediterranean regions, so evidence-based decisions about the use of meningococcal vaccines can be made.

Temporal upregulation of host surface receptors provides a window of opportunity for bacterial adhesion and disease

“…The major central nervous system disease, meningitis, is manifested by a specific and limited number of bacterial pathogens, including Streptococcus pneumoniae, and N. meningitidis. The global incidence of pneumococcal meningitis was 0.1 million in children younger than 5 years in 2000, while the worldwide annual prevalence of meningococcal meningitis is 1.2 million with 135 000 deaths yearly [60,61]. Pneumococci utilize a similar set of host surface receptors, including PAFR, for both adherence to the respiratory epithelium and for penetrating the endothelial lining of the blood-brain barrier [34].…”

Meningococcal quadrivalent tetanus toxoid conjugate vaccine (MenACWY-TT, Nimenrix™): A review of its immunogenicity, safety, co-administration, and antibody persistence

“…14 In Asia, there is limited data on the circulating serogroups, but serogroups A and C have been mainly reported. 9,14 However, Saudi Arabia has experienced some outbreaks with W serogroup during pilgrimage seasons. 9,17 Most cases are sporadic and less likely occur as part of outbreaks.…”

“…9,14 However, Saudi Arabia has experienced some outbreaks with W serogroup during pilgrimage seasons. 9,17 Most cases are sporadic and less likely occur as part of outbreaks. During epidemics, a single serogroup usually predominates and a shift toward older ages is noted.…”

Safety and immunogenicity of meningococcal ACWY CRM197-conjugate vaccine in children, adolescents and adults in Russia

“…1,3 Approximately 1.2 million cases of IMD occur annually worldwide, resulting in about 135 000 deaths per year. 4 Incidence rates are higher among children, in whom protective antibodies have not yet developed, in teenagers, and in young adults, with an increasing probability of developing severe disease with age. 5,6 Twelve different serogroups of Neisseria meningitidis have been identified to date, 7 but the vast majority (>90%) of invasive meningococcal infections and epidemics are caused by organisms expressing one of the serogroup A, B, C, X, W-135, or Y capsular polysaccharide.…”

“…2 The incidence and serogroup distribution of meningococcal disease are highly variable between countries and change over seasons and years: serogroups B and C predominate in Europe, Australia, and New Zealand; serogroups A, C, and W-135 are most common in Asia and Africa; serogroups B, C, and Y prevail in Canada, US, the Caribbean, and Latin America, and serogroup X has caused sporadic and clustered meningitis cases in sub-Saharan Africa. 4 Neisseria meningitidis is the leading cause of bacterial invasive infections in people aged <15 years in the Russian Federation. The aim of this phase III, multicenter, open-label study was to assess the immunogenicity and safety of the quadrivalent meningococcal cRM 197 -conjugate vaccine MenacWY when administered to healthy Russian subjects aged 2 years and above.…”