Meningococcal disease in North America: Updates from the Global Meningococcal Initiative

Area of Science:

• Public Health
• Epidemiology
• Infectious Diseases

Background:

• Invasive meningococcal disease (IMD) surveillance relies on passive and active networks across North America.
• While IMD incidence has declined in some regions like the Dominican Republic and Panama, significant regional and temporal variations exist.
• Outbreaks continue to affect specific subpopulations, including homeless individuals in the US and migrants in Mexico.

Purpose of the Study:

• To review the recent Global Meningococcal Initiative (GMI) regional meeting focused on meningococcal disease in North America.
• To highlight emerging challenges such as antibiotic resistance and the impact of public health crises on disease control.
• To discuss current vaccination practices, vaccine effectiveness, and future surveillance strategies.

Main Methods:

• Summary of discussions and findings from the GMI regional meeting.
• Review of epidemiological data on IMD cases and trends.
• Analysis of surveillance data, including whole genome sequencing for strain identification.

Main Results:

• IMD incidence shows a decreasing trend in many North American areas, but with notable variations.
• Emergence of β-lactamase-positive and ciprofloxacin-resistant *Neisseria meningitidis* in the US is a significant concern.
• While conjugate vaccines offer herd protection, group B vaccines do not appear to reduce meningococcal carriage.

Conclusions:

• Enhanced disease surveillance and timely catch-up vaccination schedules are crucial, especially after public health crises.
• Whole genome sequencing is vital for tracking IMD strain emergence and evaluating vaccine effectiveness.
• The Global Roadmap on Defeating Meningitis by 2030 remains a central objective for the GMI.