Can we, should we, eradicate the meningococcus?

Area of Science:

• Microbiology
• Immunology
• Public Health

Background:

• Infectious disease control often aims for pathogen eradication, a feat achieved only for smallpox virus in humans.
• Neisseria meningitidis (meningococcus) is an obligate human bacterium causing significant disease, prompting consideration of its eradication.
• Advances in conjugate vaccines offer potential for interrupting meningococcal transmission.

Purpose of the Study:

• To evaluate the feasibility of controlling, eliminating, or eradicating Neisseria meningitidis.
• To weigh the factors supporting and opposing eradication efforts.
• To determine achievable public health goals for meningococcal disease.

Main Methods:

• Literature review and analysis of Neisseria meningitidis characteristics.
• Assessment of epidemiological factors relevant to eradication.
• Consideration of vaccine efficacy and limitations.

Main Results:

• Factors favoring eradication include limited serogroups, no animal reservoir, and disease burden.
• Factors against eradication include commensalism, high population diversity, and lack of comprehensive vaccines.
• Potential harm from microbiome perturbation is a concern.

Conclusions:

• Eradication of Neisseria meningitidis is not currently feasible.
• Control and elimination of disease caused by specific pathogenic meningococcal genotypes is a more realistic objective.
• Focus should be on managing disease associated with particular strains rather than total eradication.