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Meningococcal disease
Ziad A Memish1, Abdulrahman A Alrajhi
1Department of Medicine and Infection Prevention and Control, King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia.
Abstract:
Meningococcal disease occurs as both endemic and epidemic disease in most parts of the world with significant morbidity and mortality. Among the different serogroups of Neisseria meningitidis, serogroups A, B, C account for 90% of the disease. In the last few years there has been a change in the epidemiology of the disease with an increase in the prevalence of serogroup C in Europe and North America, serogroup Y in the United States of America and Sweden, and W135 in the Kingdom of Saudi Arabia. The emergence of Neisseria meningitidis serogroup W135 in the Kingdom of Saudi Arabia has lead to 2 major outbreaks mainly among Pilgrims during the Hajj season of 2000 and 2001. This has lead the health officials in the Kingdom of Saudi Arabia to change their vaccine requirements for the Umra and Hajj to include the quadrivalent meningococcal vaccine (A, C, Y, W135) instead of the bivalent one (A, C). Despite all the advances in prevention, diagnosis and treatment, the disease continues to have high mortality (5-10%). Prompt empirical treatment for suspected cases should include penicillin or a 3rd generation cephalosporin. A new conjugate vaccine against Neisseria meningitidis serogroup C has been recently licensed, while quadrivalent conjugate vaccine against serogroup A, C, Y and W135 is in early development. Meanwhile targeted vaccination with the available vaccines according to the epidemiology of the disease and rapid chemoprophylaxis for the close contacts of active cases are the most effective preventive strategies.
Insights
Meningococcal disease, caused by Neisseria meningitidis, remains a significant threat globally. Updated vaccination strategies, including quadrivalent vaccines, are crucial for controlling outbreaks and reducing mortality.
Area of Science:
- Epidemiology
- Infectious Diseases
- Vaccinology
Background:
- Meningococcal disease causes significant global morbidity and mortality.
- Serogroups A, B, and C of Neisseria meningitidis are responsible for 90% of cases.
- Recent epidemiological shifts show increased prevalence of serogroups C, Y, and W135 in various regions.
Purpose of the Study:
- To highlight the changing epidemiology of meningococcal disease.
- To discuss the impact of Neisseria meningitidis serogroup W135 outbreaks in Saudi Arabia.
- To review current and developing prevention and treatment strategies for meningococcal disease.
Main Methods:
- Review of epidemiological data on Neisseria meningitidis serogroups.
- Analysis of outbreak investigations, particularly during Hajj seasons.
- Evaluation of vaccine requirements and treatment protocols.
Main Results:
- Neisseria meningitidis serogroup W135 emergence led to major outbreaks in Saudi Arabia during Hajj.
- Vaccine requirements in Saudi Arabia were updated to include quadrivalent meningococcal vaccines (A, C, Y, W135).
- Meningococcal disease continues to have a high mortality rate (5-10%) despite advances.
Conclusions:
- Targeted vaccination based on disease epidemiology is essential.
- Rapid chemoprophylaxis for close contacts is a key preventive measure.
- Development of new conjugate vaccines, including quadrivalent options, is ongoing and critical for future control.