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Epidemiology of pathogenic Neisseria meningitidis serogroup B serosubtypes in Malta: implications for introducing

David Pace1, Paul Cuschieri, Anthony Galea Debono

  • 1Department of Paediatrics, Mater Dei Hospital, MSD, Malta. dpace@mail.global.net.mt

Vaccine
|September 20, 2008
PubMed
Abstract

Insights

Neisseria meningitidis serogroup B (MenB) is a significant cause of invasive meningococcal disease in Malta, particularly in children. While a specific MenB Porin A (PorA) OMV vaccine shows promise against prevalent strains, broader protection may require multivalent or conserved protein vaccines.

Area of Science:

  • Epidemiology
  • Vaccinology
  • Microbiology

Background:

  • Neisseria meningitidis serogroup B (MenB) is a leading cause of bacterial meningitis and sepsis.
  • Invasive meningococcal disease (IMD) epidemiology varies geographically and temporally.
  • Porin A (PorA) based outer membrane vesicle (OMV) vaccines are a strategy for MenB prevention.

Purpose of the Study:

  • To determine the epidemiology of Neisseria meningitidis serogroup B (MenB) serosubtypes in Malta, a densely populated European region.
  • To evaluate the potential of Porin A (PorA) based outer membrane vesicle (OMV) vaccines for broad MenB protection.

Main Methods:

  • Active surveillance of invasive meningococcal disease (IMD) in Malta from 1999-2006.
  • Serogroup B isolates were analyzed for serosubtyping, age distribution, and prevalence.
  • Suitability of OMV vaccines was assessed based on isolate characteristics.

Main Results:

  • Serogroup B accounted for 76% of IMD cases, with the highest burden in children aged 0-14 years.
  • The most common MenB serotype:serosubtype was B:4:P1.19,15 (59%).
  • PorA epitopes P1.15 and P1.19 were significantly more prevalent in MenB isolates.

Conclusions:

  • Further research is needed to assess MenB OMV vaccine utility in Malta.
  • A wild-type OMV vaccine could target the prevalent B:4:P1.19,15 clone.
  • Broader protection against heterogeneous MenB strains may necessitate multivalent OMV vaccines or vaccines targeting conserved proteins.

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