The efficacy of meningococcal polysaccharide vaccine in preventing group A meningococcal disease in The Gambia, West Africa

Greenwood, Brian; Smith, A.; Hassan-King, Musa; Bijlmer, H. A.; Shenton, Fiona C.; Hughes, Andrew; Nunn, Paul; Jack, A; Cowers, P.R.S.

doi:10.1016/0035-9203(86)90303-2

Cited by 25 publications

(12 citation statements)

References 3 publications

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“…We evaluated immunogenicity pre-and postvaccination in adolescents given a MenA conjugate vaccine or an unconjugated polysaccharide control vaccine for which vaccine efficacy has been fully demonstrated (2,7,29). Increases in seropositivity/seroprotection rates after vaccination with polysaccharide vaccine were detected with either of the L10-SBAs and with the L11-hSBA.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Functional Anti-Meningococcal Serogroup A Activity Using Strain 3125 as the Target Strain for Serum Bactericidal Assay

Poolman

Vleeschauwer

Durant

et al. 2011

Clin. Vaccine Immunol.

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Functional anti-N. meningitidis serogroup A (MenA) activity in human serum is detected by serum bactericidal assay (SBA), using either rabbit (rSBA) or human (hSBA) complement, with F8238 as the recommended MenA SBA target strain. However, the F8238 strain may not be optimal for this purpose because, as we show here, it expresses the L11 immunotype, whereas most MenA invasive strains express the L(3,7)9 or L10 immunotype. Moreover, SBA results may be strain dependent, because immunotypes differ in their sensitivity to complement, emphasizing the need to choose the most appropriate strain. Sera from random subsets of infants, toddlers, children, and adolescents in clinical trials of MenA conjugate vaccines were tested by rSBA using strains 3125 (L10) and F8238 (L11). In unvaccinated subjects from all age groups, the percentages of seropositive samples (rSBA-MenA titer, >1:8) was lower using strain 3125 than using strain F8238. However, in toddlers and adolescents immunized with a conjugate MenA vaccine, the percentages of seropositive samples generally were similar using either strain in the rSBA. In two studies, sera also were tested with hSBA. Using hSBA, the differences in the percentages of seroprotective samples (hSBA-MenA titer, >1:4) between strains 3125 and F8238 was less apparent, and in contrast with rSBA, the percentage of seroprotective samples from unvaccinated subjects was slightly higher using strain 3125 than using strain F8238. In adults vaccinated with plain MenA polysaccharide, the percentage of seroprotective samples was higher using strain 3125 than with strain F8238, and the vaccine response rates using strain 3125 were better aligned with the demonstrated efficacy of MenA vaccination. In conclusion, SBA results obtained using the MenA L10 3125 strain better reflected vaccine-induced immunity.The development of effective polysaccharide-protein conjugate vaccines targeting Neisseria meningitidis relies upon the measurement of bactericidal antibodies (4, 32). To ensure the quality, safety, and efficacy of N. meningitidis serogroup A (MenA) conjugate vaccines, the WHO recommends the use of any MenA strain in the serum bactericidal assay (SBA), provided that the strain is not killed by the complement in the absence of MenA-specific antibodies (33). However, strain A1, originally used by Goldschneider et al. in their classic studies (8), was shown to be too sensitive to complement killing (20). The SBA against MenA that has been proposed by Maslanka et al. (20) uses rabbit complement and MenA strain F8238.Clinical trials with MenA polysaccharide-protein conjugate vaccines showed a high percentage of control subjects, not vaccinated with a MenA vaccine, who became SBA positive (with rabbit complement 2nd strain F8238) between 18 weeks of age and the second year of life (5). However, these subjects did not display a parallel increase in anti-capsular polysaccharide A IgG, suggesting that part of the positive SBA results, referred to as natural immunity, was related to either noncapsular surface an...

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Section: Discussionmentioning

confidence: 99%

Measurement of Functional Anti-Meningococcal Serogroup A Activity Using Strain 3125 as the Target Strain for Serum Bactericidal Assay

Poolman

Vleeschauwer

Durant

et al. 2011

Clin. Vaccine Immunol.

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“…Bacteria isolated in The Gambia during the epidemic of 1982-83 belonged almost exclusively to serogroup A, subgroup IV-1 (Greenwood et al 1986;Crowe et al 1989). This epidemic was controlled by a vaccination campaign using a combined group A and C meningococcal polysaccharide vaccine.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, during the period 1981-83, when several countries in West Africa, including The Gambia, experienced an epidemic of serogroup A, subgroup IV-1 meningococcal meningitis (Greenwood et al 1986;Olyhoek et al 1987;Crowe et al 1989), Denis et al (1982) found that 21 of 349 meningococcal strains (6%) obtained from patients with endemic meningitis in Dakar, Senegal or from patients with endemic or epidemic meningitis in Niamey, Niger, belonged to serogroup C, and that 11 (3%) belonged to serogroup W135. Similarly, 3 of 41 cases of meningococcal meningitis (7%) observed in The Gambia between December 1983 and November 1985, after a serogroup A epidemic had been interrupted by vaccination with an A/C polysaccharide vaccine, were caused by meningococci belonging to serogroup W135 (Greenwood et al 1986). Between 1989 and 1992, endemic meningococcal meningitis in Bamako, Mali was caused by serogroup C meningococci of the ET-37 complex and, occasionally, by serogroup A, subgroup IV-1 bacteria (unpublished data).…”

Section: Introductionmentioning

confidence: 99%

Meningitis caused by a serogroup W135 clone of the ET‐37 complex of Neisseria meningitidis in West Africa

Kwara

Adegbola

Corrah

et al. 1998

Tropical Med Int Health

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SummaryMeningococci belonging to serogroup W135 caused several cases of meningococcal meningitis in The Gambia in 1995 and were isolated during a serogroup A epidemic in Mali in 1994. The eight isolates tested belonged to the same clone of the ET-37 complex and differed in several bands from the pulsed-field gel electrophoresis restriction pattern of serogroup C meningococci of the ET-37 complex isolated in Mali. Three of 6 patients infected in The Gambia died, indicating that this W135 clone is virulent. Vaccines that protect only against infections with meningococci belonging to serogroups A and C are usually used to control outbreaks in Africa, although vaccines containing the W135 polysaccharide are available. The findings of this study indicate that outbreaks of meningococcal meningitis in Africa can be associated with serogroup W135 infections and that serogrouping is essential before vaccination campaigns are started.keywords Meningococcus, West Africa, vaccination correspondence B M Greenwood,

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“…This small scale selective vaccination did not prevent further spread of the disease in the area; therefore, a large scale vaccination campaign covering nearly 100% of students aged 10-19 years (13300 students) was organized which did stop further spread of the disease [33]. Further evidence that selective vaccination may be cost-effective in the control of meningococcal disease was observed in Nigeria [29] where vaccination was conducted in villages (total population 10000) suffering from outbreaks of meningococcal disease; this selective vaccination stopped the spread of meningococcal disease in vaccinated villages, while it continued in control villages. Another example of successful intervention in an outbreak caused by Neisseria meningitidis group A by targeted vaccination was reported from Auckland, New Zealand [43].…”

Section: Resultsmentioning

confidence: 99%

“…Meningococcal polysaccharide vaccines are not used in routine immunization programmes and their use depends on epidemiological indications [24,25]; most often, they are used for targeted vaccination of populations exposed during outbreaks, and in some countries for vaccination of military recruits [26,27]. It has been reported that well organized vaccination campaigns have stopped epidemics of meningococcal invasive disease [28][29][30][31][32][33].…”

Section: Introductionmentioning

confidence: 99%

Targeted vaccination with meningococcal polysaccharide vaccine in one district of the Czech Republic

Kriz

Vlčková²,

Bobák

1995

Epidemiol. Infect.

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SummaryVaccination againstNeisseria meningitidisis not part of routine immunization schemes in any country; instead, targeted vaccination of groups at the highest risk is recommended during outbreaks and epidemics. After a long period of sporadic occurrence of meningococcal invasive disease, a new clone ofNeisseria meningitidisC: 2a: P1.2, ET-15/37, occurred in the Czech Republic, and caused local outbreaks in two neighbouring districts, Olomouc and Bruntal, in spring 1993. In Olomouc, a mass campaign was conducted during which 6191 students were vaccinated (5·6 % of the total population of this locality and 96% of all students in the age group 15–19) within 2 weeks in June 1993. In Bruntal district, no such campaign was organized. In Olomouc, the incidence of invasive disease caused byNeisseria meningitidisC in the age group 10–24 decreased from 57 to 0 per 100000 (P < 0·001) during the post-vaccination period (July 1993–August 1994), but no such decrease was observed in Bruntal. Although other factors can affect the frequency of disease, these results support the current recommendations of targeted vaccination in outbreaks of meningococcal disease.

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The efficacy of meningococcal polysaccharide vaccine in preventing group A meningococcal disease in The Gambia, West Africa

Cited by 25 publications

References 3 publications

Measurement of Functional Anti-Meningococcal Serogroup A Activity Using Strain 3125 as the Target Strain for Serum Bactericidal Assay

Measurement of Functional Anti-Meningococcal Serogroup A Activity Using Strain 3125 as the Target Strain for Serum Bactericidal Assay

Meningitis caused by a serogroup W135 clone of the ET‐37 complex of Neisseria meningitidis in West Africa

Targeted vaccination with meningococcal polysaccharide vaccine in one district of the Czech Republic

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