Meningococcal disease in travelers

Abstract

The vaccine of choice for travelers at risk of invasive meningococcal disease is a tetravalent conjugate meningococcal vaccine. Data on the need for re-vaccination schedules are still lacking, and so are data on immunogenicity in very young children and the elderly. The first vaccine against serogroup B may become available in early 2013 thus expanding the options of broadening the protection against more serogroups for travelers. Furthermore, the development of pentavalent vaccines will increase the uptake of meningococcal vaccines in the future.

Review of meningococcal vaccines with updates on immunization in adults

“…31,130 The conjugate vaccine is preferred for use in Hajj pilgrims due to concerns of hyporesponsiveness with repeated doses of MPV as many individuals participate in repeat pilgrimages. 131 Seven to 10 d post-vaccination are required to develop appreciable antibodies and achieve protection against meningococcal disease.…”

“…47 However, MPV can be given in case of allergy to the conjugate vaccine, age >55 y, unavailability or high expenses of MCV, and travel for a limited period of time to a hyperendemic or epidemic area. 31 However, its use is limited in the case of routine use in the general population. 122,123 The ACIP of the CDC recommends the use of MPV-4 in adults >55 y.…”

“…18 The FDA extended the age of vaccination in 2007 to include 2-to 10-y-old children, and in 2011, infants 9-23 mo of age were also included in the immunization schedule. 31 MenACWY-DT is approved as a two-dose series for children aged 9-23 mo and as a single dose in people aged 2-55 y. 60 Immunogenicity and effectiveness In adults aged 18-55 y, non-inferiority of MenACWY-DT to MPV-4 was assessed by the similar proportion of participants with at least 4-fold rise in SBA titers against each of the 4 serogroups.…”

“…35 Fortunately, no further outbreaks have occurred due to the shift in vaccination to the quadrivalent (A, C, W-135, and Y) polysaccharide vaccine as a Hajj visa requirement in 2002. 31,36,37 Australia and New Zealand Serogroups B and C predominate in Australia with a prolonged serogroup B epidemic in New Zealand during the 1990s. 3 In the mid-1990s, there were a rise in cases of meningococcal C disease in Australia.…”

Vaccine-Preventable Diseases in Travelers

“…The Hajj pilgrimage to Saudi Arabia has been associated with outbreaks of meningococcal disease in returning pilgrims and their household contacts [18]. There have been several significant achievements in the field of meningococcal vaccine development during the past few years [19]. Two tetravalent conjugate vaccines and one tetravalent polysaccharide vaccine are currently available to international travelers and contain serotypes A, C, Y, W135.…”