The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Abstract

2019) The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and highrisk populations, Expert Review of Vaccines, 18:1, 15-30, ABSTRACT Introduction: The 2018 Global Meningococcal Initiative (GMI) meeting focused on evolving invasive meningococcal disease (IMD) epidemiology, surveillance, and protection strategies worldwide, with emphasis on emerging antibiotic resistance and protection of high-risk populations. The GMI is comprised of a multidisciplinary group of scientists and clinicians representing institutions from several continents. Areas covered: Given that the incidence and prevalence of IMD continually varies both geographically and temporally, and surveillance systems differ worldwide, the true burden of IMD remains unknown. Genomic alterations may increase the epidemic potential of meningococcal strains. Vaccination and (to a lesser extent) antimicrobial prophylaxis are the mainstays of IMD prevention. Experiences from across the globe advocate the use of conjugate vaccines, with promising evidence growing for protein vaccines. Multivalent vaccines can broaden protection against IMD. Application of protection strategies to high-risk groups, including individuals with asplenia, complement deficiencies and human immunodeficiency virus, laboratory workers, persons receiving eculizumab, and men who have sex with men, as well as attendees at mass gatherings, may prevent outbreaks. There was, however, evidence that reduced susceptibility to antibiotics was increasing worldwide. Expert commentary: The current GMI global recommendations were reinforced, with several other global initiatives underway to support IMD protection and prevention. ARTICLE HISTORY

Prevention and control of meningococcal disease: Updates from the Global Meningococcal Initiative in Eastern Europe

“…34 As such, the GMI recommends that conjugate vaccines replace plain polysaccharide vaccines whenever cost, availability, licensing, and immunization policy allow. 9 A number of conjugate vaccines are available world-wide, although it should be noted that their availability varies from country to country. 9 As discussed previously, 9 introduction of the conjugate meningococcal serogroup C (MenC) vaccine in the UK infant immunization schedule in 1999, with a catch-up program for all children and adolescents under the age of 18 years, led to a rapid decline in the incidence of MenC disease, with reductions observed in carriage ( Fig.…”

“…The emergence of antibiotic resistance is a growing problem worldwide. 9 Nm is generally susceptible to the antibiotics used in the treatment and prevention of IMD. However, isolates with reduced susceptibility to penicillin are increasing 9 , 70 and can arise through alterations of penicillin binding protein 2 (PBP2) involved in cell wall synthesis or from the production of beta-lactamase (an enzyme that inactivates beta-lactams).…”

Comparative genomic analyses of Chinese serogroup W ST-11 complex Neisseria meningitidis isolates

“…Due to the high case fatality rate and ease of international spread, W:cc11 has been of major focus globally. 22,23 The evolution and spread of W:cc11 together with other serogroup cc11 strains has been widely published but not for China. 9,24,25 Genomic analyses based on geo-temporally diverse isolates has shown a complex population structure for cc11.…”

Protecting the most vulnerable age group: a review of MenACWY-TT immunogenicity and safety in infants

“…Meningococcal serogroup B (MenB) is currently a major cause of IMD in Europe, North America, South America, Australia, and North Africa, although a decreasing incidence trend is being observed worldwide [7][8][9]. Serogroup C (MenC) is also reported as one of the most frequent serogroups causing IMD in North America, Brazil, Europe, and Asia and was the cause of the largest-ever global MenC epidemic reported, initially in Niger and then Nigeria (associated with a novel hyperinvasive MenC strain, ST-10,217, only circulating in Africa) [7,8,10]. Serogroup A (MenA), previously responsible for large epidemics in the African meningitis belt, is now a rare cause of disease in this region after the introduction of an effective immunization program [10,11].…”

“…Serogroup C (MenC) is also reported as one of the most frequent serogroups causing IMD in North America, Brazil, Europe, and Asia and was the cause of the largest-ever global MenC epidemic reported, initially in Niger and then Nigeria (associated with a novel hyperinvasive MenC strain, ST-10,217, only circulating in Africa) [7,8,10]. Serogroup A (MenA), previously responsible for large epidemics in the African meningitis belt, is now a rare cause of disease in this region after the introduction of an effective immunization program [10,11]. A recent increase in meningococcal serogroup W (MenW) disease has been documented across several countries in various global regions [12].…”