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Meningococcal disease in childhood: epidemiology, clinical features and prevention
S Bosis1, A Mayer1, S Esposito1
1Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
Abstract:
Invasive meningococcal disease (IMD) represents a public health problem and a leading cause of morbidity and mortality worldwide. IMD can occur as an endemic disease with sporadic cases or epidemics with outbreaks. Neisseria meningitis strains are divided into 13 serogroups, but only five (A, B, C, W-135, and Y) are responsible for most IMD across the world. All age groups are at risk for IMD, but infants and adolescents are particularly vulnerable. The most common clinical manifestations of IMD are meningitis and septicemia, although in some cases both clinical pictures are present. The clinical pattern can differ according to age; in young children, the clinical manifestations may be more insidious and the diagnosis may be more difficult compared to older children or adolescents. Death occurs in 6-10% of cases and sequelae in 4.3-11.2% of cases. Early recognition of children with meningococcal infection is important in order to initiate systemic antibiotic therapy, although vaccination remains the best strategy to control meningococcal disease. Recently, different meningococcal vaccines have been introduced worldwide, resulting in a reduction in the overall burden of the disease. The goal of the next few years should be to increase vaccination coverage against meningococcal diseases, continue to monitor IMD and develop a unique vaccine able to cover all of the main meningococcal strains.
Insights
Invasive meningococcal disease (IMD) is a global health threat, particularly affecting infants and adolescents. Vaccination is the most effective strategy to control IMD, with ongoing efforts to improve coverage and develop broader vaccines.
Area of Science:
- Public Health
- Infectious Diseases
- Vaccinology
Background:
- Invasive meningococcal disease (IMD) is a significant cause of global morbidity and mortality.
- Neisseria meningitidis serogroups A, B, C, W-135, and Y are responsible for the majority of IMD cases worldwide.
- Infants and adolescents are particularly vulnerable populations for IMD.
Purpose of the Study:
- To highlight the public health impact of IMD.
- To emphasize the importance of early diagnosis and treatment of IMD.
- To advocate for increased vaccination coverage and the development of comprehensive meningococcal vaccines.
Main Methods:
- This study reviews existing literature on IMD epidemiology, clinical manifestations, and control strategies.
- It analyzes the effectiveness of current meningococcal vaccines.
- It discusses the challenges and future directions in IMD prevention and management.
Main Results:
- IMD presents with meningitis and/or septicemia, with varied clinical presentations across age groups.
- Mortality rates for IMD range from 6-10%, with sequelae affecting 4.3-11.2% of survivors.
- Recent advances in meningococcal vaccines have led to a reduction in the global burden of IMD.
Conclusions:
- Early recognition and antibiotic therapy are crucial for managing IMD, but vaccination remains the primary prevention strategy.
- Increasing vaccination coverage and continued surveillance are essential for controlling IMD.
- Future research should focus on developing a universal vaccine effective against all major meningococcal serogroups.
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