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PLoS One 2021 14;16(5):e0251494. Epub 2021 May 14.

Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States of America.

Encephalitis and meningitis (EM) are severe infections of the central nervous system associated with high morbidity and mortality. The etiology of EM in Kazakhstan is not clearly defined, so from February 1, 2017 to January 31, 2018 we conducted hospital-based syndromic surveillance for EM at the Shymkent City Hospital, in the South Kazakhstan region. All consenting inpatients meeting a standard case definition were enrolled. Read More

Front Public Health 2021 26;9:651100. Epub 2021 Apr 26.

School of Specialization in Occupational Medicine, University of Pisa, Pisa, Italy.

Following an outbreak of meningococcal epidemic in 2015 and 2016 in Tuscany, we registered a higher demand for antimeningococcal vaccination (anti-Men ACWY) by Healthcare Workers of the University Hospital of Pisa [Azienda Ospedaliero Universitaria Pisana (AOUP)]. The purpose of this work is to analyze and discuss data on vaccination coverage resulting from this vaccination campaign. We conducted a monocentric study about anti-Men vaccination in the healthcare workers of the AOUP following the outbreak of meningococcal meningitis that occurred mainly in the population of the Tuscan provinces of Pisa, Pistoia, Prato, and Florence. Read More

J Infect 2021 Apr 29. Epub 2021 Apr 29.

GSK, Rockville, MD, USA.

Objectives: 4CMenB is a broadly protective vaccine against invasive meningococcal capsular group B disease (MenB IMD). Licensed worldwide based on immunogenicity and safety data, effectiveness and impact data are now available. We comprehensively reviewed all available real-world evidence gathered from use of 4CMenB since licensure. Read More

Microorganisms 2021 Apr 7;9(4). Epub 2021 Apr 7.

Center for Vaccine Innovation and Access, PATH, Seattle, WA 98121, USA.

Despite advances in the development and introduction of vaccines against the major bacterial causes of meningitis, the disease and its long-term after-effects remain a problem globally. The Global Roadmap to Defeat Meningitis by 2030 aims to accelerate progress through visionary and strategic goals that place a major emphasis on preventing meningitis via vaccination. Global vaccination against type B (Hib) is the most advanced, such that successful and low-cost combination vaccines incorporating Hib are broadly available. Read More

Arch Pediatr 2021 Apr 23. Epub 2021 Apr 23.

CHU de Nantes, Department of Pediatrics, Nantes, France.

Background: Infectious diseases are still an important cause of morbidity and mortality in high-income countries and may preferentially affect predisposed children, especially immunocompromised children. We aimed to evaluate the frequency of recommended immunological tests in children with community-onset severe bacterial infection (COSBI) admitted to a pediatric intensive care unit. We also assessed the frequency and described the typology of diagnosed primary immune deficiency (PID). Read More

Lancet Child Adolesc Health 2021 Apr 21. Epub 2021 Apr 21.

Maternal, Adolescent, Reproductive & Child Health Centre and Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK. Electronic address:

Background: Group B Streptococcus (GBS) disease is a leading cause of neonatal death, but its long-term effects have not been studied after early childhood. The aim of this study was to assess long-term mortality, neurodevelopmental impairments (NDIs), and economic outcomes after infant invasive GBS (iGBS) disease up to adolescence in Denmark and the Netherlands.

Methods: For this cohort study, children with iGBS disease were identified in Denmark and the Netherlands using national medical and administrative databases and culture results that confirmed their diagnoses. Read More

Expert Rev Vaccines 2021 Apr 29:1-11. Epub 2021 Apr 29.

Department of Paediatrics, University Hospitals of Geneva, Geneva, Switzerland.

: Besides meningococcal disease, the African meningitis belt (AMB) region is also affected by pneumococcal disease. Most AMB countries have introduced pneumococcal conjugate vaccines (PCV) following a schedule of three primary doses without a booster or a catch-up campaign. PCV is expected to help control pneumococcal disease through both direct and indirect effects. Read More

Eur J Health Econ 2021 Apr 9. Epub 2021 Apr 9.

Centre for Economic and Regional Studies, Lendület Health and Population Research Group, Tóth Kálmán utca 4, Budapest, 1097, Hungary.

We estimate the effect of mass media coverage of the meningococcal disease on the uptake of meningococcal vaccinations in Hungary. Our analysis is based on administrative county-level data on vaccination purchases linked to indicators of media coverage of the meningococcal disease and to administrative records of disease incidence. Using geographical and time variations in these indicators, our fixed effects estimates indicate a strong positive effect of mass media coverage of the disease on the rate of vaccination with all types of the meningococcal vaccine. Read More

Microorganisms 2021 Mar 3;9(3). Epub 2021 Mar 3.

Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.

, carried in the human nasopharynx asymptomatically by ~10% of the population, remains a leading cause of meningitis and rapidly fatal sepsis, usually in otherwise healthy individuals. The epidemiology of invasive meningococcal disease (IMD) varies substantially by geography and over time and is now influenced by meningococcal vaccines and in 2020-2021 by COVID-19 pandemic containment measures. While 12 capsular groups, defined by capsular polysaccharide structures, can be expressed by , groups A, B, and C historically caused most IMD. Read More

PLoS Pathog 2021 Mar 26;17(3):e1009461. Epub 2021 Mar 26.

GSK, Siena, Italy.

Neisseria meningitidis is a strictly human pathogen and is the major cause of septicemia and meningitis worldwide. Factor H binding protein (fHbp) is a meningococcal surface-exposed lipoprotein that binds the human Complement factor H allowing the bacterium to evade the host innate immune response. FHbp is also a key antigen in two vaccines against N. Read More

J Clin Pharm Ther 2021 Mar 25. Epub 2021 Mar 25.

School of Medicine, Dentistry and Biomedical Sciences, The Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, Northern Ireland, UK.

What Is Known And Objective: Patient information leaflets (PILs) or Patient Leaflets (PLs) formally accompany dispensed medicines and are intended to provide the patient with information on how to use the medicine safely. To date, there have been no studies that have examined the readability of meningococcal vaccine patient-facing information, including information contained within the vaccine PIL. Given the role of pharmacists in presenting PILs to patients, it was, therefore, the aim of this study to quantitatively analyse the readability of Patient Leaflets, which accompany licensed meningococcal vaccines in the UK and US and to compare PILs to vaccine pharmaceutical manufacturers' summary of product characteristics (SPC), as well as other patient-facing vaccine-related information. Read More

Emerg Infect Dis 2021 Apr;27(4):1087-1097

Genomic surveillance is an essential part of effective disease control, enabling identification of emerging and expanding strains and monitoring of subsequent interventions. Whole-genome sequencing was used to analyze the genomic diversity of all Neisseria meningitidis isolates submitted to the New Zealand Meningococcal Reference Laboratory during 2013-2018. Of the 347 isolates submitted for whole-genome sequencing, we identified 68 sequence types belonging to 18 clonal complexes (CC). Read More

Emerg Infect Dis 2021 Apr;27(4):1110-1122

Expansion of quinolone-resistant Neisseria meningitidis clone China from sequence type (ST) 4821 clonal complex (CC4821) caused a serogroup shift from serogroup A to serogroup C invasive meningococcal disease (IMD) in China. To determine the relationship among globally distributed CC4821 meningococci, we analyzed whole-genome sequence data from 173 CC4821 meningococci isolated from 4 continents during 1972-2019. These meningococci clustered into 4 sublineages (1-4); sublineage 1 primarily comprised of IMD isolates (41/50, 82%). Read More

Vaccine 2021 Apr 16;39(15):2177-2182. Epub 2021 Mar 16.

Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo 1628640, Japan; Department of Clinical Research, National Mie Hospital, 357 Ohsato-Kubota-cho, Tsu-shi, Mie 5140125, Japan.

Purpose: The first outbreak of invasive meningococcal disease (IMD) in decades occurred in a high school dormitory in 2011. This report aims to describe the results of the IMD outbreak investigation and to discuss current issues of IMD in Japan.

Methods: We conducted an epidemiological and microbiological investigation against the IMD outbreak of serogroup B among students and staff in a high school dormitory. Read More

Pan Afr Med J 2020 5;35(Suppl 2):20. Epub 2020 May 5.

School of Public Health, University of Health and Allied Sciences, Ho, Ghana.

Vaccine 2021 Mar 15;39(11):1621-1630. Epub 2021 Feb 15.

Second Dept of Paediatrics, Medical School, National Kapodistrian University, Athens, Greece.

Invasive meningococcal disease (IMD) is associated with high case fatality rates and long-term sequelae among survivors. Meningococci belonging to six serogroups (A, B, C, W, X, and Y) cause nearly all IMD worldwide, with serogroup B meningococci (MenB) the predominant cause in many European countries, including Greece (~80% of all IMD). In the absence of protein-conjugate polysaccharide MenB vaccines, two protein-based vaccines are available to prevent MenB IMD in Greece: 4CMenB (Bexsero™, GlaxoSmithKline), available since 2014; and MenB-FHbp, (Trumenba™, Pfizer), since 2018. Read More

PLoS Pathog 2021 Feb 16;17(2):e1009299. Epub 2021 Feb 16.

Université de Paris, Faculté de Médecine, Paris, France.

Neisseria meningitidis (the meningococcus) remains a major cause of bacterial meningitis and fatal sepsis. This commensal bacterium of the human nasopharynx can cause invasive diseases when it leaves its niche and reaches the bloodstream. Blood-borne meningococci have the ability to adhere to human endothelial cells and rapidly colonize microvessels. Read More

Hum Vaccin Immunother 2021 Feb 10:1-8. Epub 2021 Feb 10.

Key Laboratory of the Ministry of Health for Research on Quality and Standardization of Biotech Products, National Institutes of Food and Drug Control, Beijing, People's Republic of China.

Meningococcal meningitis caused by is a reportable infectious disease in China, due to the high incidence of meningitis in the era before the availability of vaccines. The disease incidence was markedly reduced after meningococcal vaccination was introduced in the 1980s. Currently, there are polysaccharide, conjugate, and combined vaccine formulations against meningococcal meningitis in the Chinese market, almost all of which are produced by domestic manufacturers. Read More

Int Immunopharmacol 2021 Apr 4;93:107411. Epub 2021 Feb 4.

China School of Public Health, University of South China, Hengyang 421001, China. Electronic address:

Neisseria meningitidis (N. meningitidis) is a human-specific pathogen and a major cause of meningitis and septicemia with a high case fatality rate. N. Read More

J Med Microbiol 2021 Mar 5;70(3). Epub 2021 Feb 5.

Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.

Invasive meningococcal disease (IMD) is a major cause of meningitis and septicaemia worldwide. The switches in serogroup predominance contribute to the unpredictable nature of the disease with significant health impacts. The aim of this study was to determine the epidemiological profile of IMD in Rio Grande do Sul, Santa Catarina and Paraná, three states in the south of Brazil. Read More

BMJ Case Rep 2021 Feb 4;14(2). Epub 2021 Feb 4.

Department of Intensive Care, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal.

Waterhouse-Friderichsen syndrome (WFS), defined as severe adrenal insufficiency due to bilateral adrenal gland haemorrhagic necrosis, occurred in a 59-year-old woman. An underlying serogroup Y (NM) infection was diagnosed, with a rapid progression to purpura fulminans, disseminated intravascular coagulation and WFS. Intensive treatment including fluid resuscitation, broad-spectrum antibiotic therapy, ventilatory support, platelet and factor replacement were administered. Read More

Biologicals 2021 Apr 29;70:53-58. Epub 2021 Jan 29.

Division of Bacteriology, National Institute for Biological Standards and Control, Blanche Lane, Potters Bar, Hertfordshire, EN6 3QG, UK.

Potency of meningococcal polysaccharide-protein conjugate vaccines relies on the polysaccharide content to prevent meningitis. NIBSC, as the official national control laboratory in UK, analysed ten different mono- and multi-meningococcal conjugate vaccines, using established International Standards for meningococcal serogroups A, C, W, Y and X, by resorcinol or HPAEC-PAD assay. Most saccharide contents were within ±20% of their claimed content for licensure with taking different O-acetylation levels into consideration, with only MenC content in two vaccines below (by 60% and 54%) the labelled value, however, previous study showed different dosage was not necessarily correlated to the immunogenicity of those vaccines. Read More

Acta Microbiol Immunol Hung 2021 Jan 27. Epub 2021 Jan 27.

2Laboratory of Medical Bacteriology, National Institute of Hygiene in Rabat, 27, Avenue Ibn Batouta, B.P. 769, Rabat 10 000, Morocco.

Bacteriological cultures from cerebrospinal fluids (CSF) have less sensitivity and specificity compared to quantitative PCR (RT-PCR), and multiple facts still conduct to the increase of negative culture. The aims of this study are to determine the molecular epidemiology and the simultaneous detection of bacterial meningitis in Morocco by using RT-PCR and compared this molecular approach with culture method to improve the etiological diagnosis of meningitis. The CSFs were collected over one-year period in 2018 in different hospitals covering all regions of the Kingdom of Morocco, from patients with suspected meningitis. Read More

J Paediatr Child Health 2021 Jan 18. Epub 2021 Jan 18.

National Centre for Immunisation Research and Surveillance, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.

Aim: To characterise the physical, psychological, and quality of life burden associated with serogroup B invasive meningococcal disease (IMD) in children.

Methods: Children aged up to 14 years at the time of serogroup B IMD, who were admitted to intensive care units of two tertiary paediatric hospitals in New South Wales, Australia between January 2009 and December 2013 were recruited. Children underwent clinical and neuropsychological assessments up to 6 years post-disease. Read More

Hum Vaccin Immunother 2021 May 11;17(5):1450-1454. Epub 2021 Jan 11.

Communicable Disease Control Branch, SA Health, Adelaide, Australia.

Invasive meningococcal disease causes significant morbidity and mortality worldwide, with serogroup B being one of the predominant serogroups in Australia for many years. The South Australian (SA) State Government recently funded the introduction of a 4CMenB vaccination program for infants, children and adolescents. In addition to protecting against invasive meningococcal disease, emerging evidence suggests the 4CMenB vaccine may also be effective against gonorrhoea due to genetic similarities between . Read More

PLoS One 2021 8;16(1):e0244889. Epub 2021 Jan 8.

Department of Infectious Diseases, Italian National Institute of Health (Istituto Superiore di Sanità), Rome, Italy.

Enhanced laboratory-based surveillance of invasive meningococcal disease (IMD) in Italy was only assessed indirectly by numerically comparing surveillance data cases with hospital discharge records (HDR). In this study, we evaluated the completeness, timeliness and sensitivity of the IMD surveillance in Italy from 2015 to 2018. Completeness and timeliness were described at the national and subnational level. Read More

Eur J Clin Microbiol Infect Dis 2021 Jan 5. Epub 2021 Jan 5.

Irish Meningitis and Sepsis Reference Laboratory, Children's Health Ireland at Temple Street, Dublin, Ireland.

This study examined the antimicrobial susceptibility of invasive meningococcal disease (IMD)-associated Neisseria meningitidis recovered in the Republic of Ireland between 1996 and 2016. In total, 1359 isolates representing over one-third of all laboratory-confirmed cases of IMD diagnosed each epidemiological year (EY; July 1-June 30) were analysed. All isolates were susceptible to ciprofloxacin, rifampicin and cefotaxime and 74% and 87% were susceptible to sulphonamide and penicillin, respectively. Read More

J Community Health 2021 Jan 2. Epub 2021 Jan 2.

Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.

Serogroup B meningococcal disease (MenB) causes almost 60% of meningitis cases among adolescents and young adults. Yet, MenB vaccine coverage among adolescents remains below 10%. Since parents are the primary medical decision makers for adolescents, we examined MenB vaccination rates and parent attitudes about meningitis and the MenB vaccine. Read More

Front Genet 2020 7;11:579411. Epub 2020 Dec 7.

Department of Genetics and Genome Biology, University of Leicester, Leicester, United Kingdom.

Rapid transmission, a critical contributory factor in outbreaks of invasive meningococcal disease, requires naïve populations of sufficient size and intermingling. We examined genomic variability and transmission dynamics in a student population subject to an 11-fold increase in carriage of a hypervirulent serogroup W ST-11 clone. Phylogenetic clusters, mutation and recombination rates were derived by bioinformatic analyses of whole-genome sequencing data. Read More

Vaccine 2021 01 24;39(3):605-616. Epub 2020 Dec 24.

GSK, Rio de Janeiro, RJ, Brazil.

Background: Meningococcal disease (MD) presents a substantial public health problem in Brazil. Meningococcal C conjugate (MenC) vaccination was introduced into the routine infant immunization program in 2010, followed by adolescent vaccination in 2017. We evaluated changes in national and regional MD incidence and mortality between 2005 and 2018, serogroup distribution and vaccine coverage. Read More