Meningococcus B: control of two outbreaks by vaccination
PDF

Keywords

Meningococcus B
vaccination
two outbreaks

Abstract

The issue of an effective vaccine against Meningococcus B (MenB) has been overcome by identifying, with the "reverse vaccinology" methodology, some antigens able of inducing a response to the majority of MenB strains circulating in the world. The new 4-components MenB vaccine (4CMenB) has been approved in Europe, Australia and Canada, and included in international pediatric immunization schedules: Australia, Canada, UK. In Italy, the first regions that have recommended vaccination against MenB were Basilicata and Puglia. The management of epidemics/outbreaks requires the implementation of a rapid response by health authorities in respect of a medical emergency with a high impact, even emotional, on the population, as recently demonstrated in two American universities. The declaration of outbreak in place has been followed in both contexts by the adoption of a procedure for the use of the 4CMenB vaccine not yet licensed in the USA. It was thus possible to organize interventions of active prophylaxis in the two campuses, establishing the first large-scale use of the new 4CMenB vaccine and achieving, in a relatively short time, high rates of vaccination coverage. With around 14,000 students immunized with at least one dose, no safety issues have been reported following immunization. Besides, to date there have been no cases in subjects who have received the vaccine. As a result of the two outbreaks described, FDA is now evaluating for the extension of the use of the 4CMenB vaccine in adolescents and young adults in USA.
https://doi.org/10.15167/2421-4248/jpmh2014.55.2.425
PDF

References

WHO , author. Meningococcal vaccines: WHO poistion paper. November 2011. Wkly Epidemiol Rec. 2011;86:521–540.

Hill DJ, Griffiths NJ, Borodina E, et al. Cellular and molecular biology of Neisseria meningitidis colonization and invasive disease. Clinical Sciences. 2010;118:547–564.

Stephens DS. Biology and pathogenesis of the evolutionarily successful, obligate human bacterium Neisseria meningitidis. Vaccine. 2009;27S:B71–B77.

Durey A, Bae SM, Lee HJ, et al. Carriage rates and serogroups of Neisseria meingitidis among freshmen in a university dormitory in Korea. Yonsei Med J. 2012;53:742–747.

Gasparini R, Comanducci M, Amicizia D, et al. Molecular and serological diversity of Neisseria meningitidis carrier strains isolated from Italian students aged 14 to 22 years. J Clin Microbiol. 2014;52:1901–1910.

Halperin SA, Bettinger JA, Greenwood BG, et al. The changing and dynamic epidemiology of meningococcal disease. Vaccine. 2012;30S:B26–B36.

Jafri RZ, Ali A, Messonnier NE, et al. Global epidemiology of invasive meningococcal disease. Population Haelth Metrics. 2013;11:17–17.

Gasparini R, Rizzetto R, Sasso T, et al. Seroprevalence of bactericidal antibody against Neisseria meningitidis serogroup C in pre-vaccinal era: the Italian epidemiological scenario. Vaccine. 2009;27:3435–3438.

Guzzetta G, Manfredi P, Gasparini R, et al. On the relationship between meningococcal transmission dynamics and disease: remarks on humoral immunity. Vaccine. 2009;27:3429–3434.

Presidenza del Consiglio dei Ministri. Intesa, ai sensi dell'articolo 8, comma 6, della legge 5 giugno 2003, n.131, tra il Governo, le Regioni e le Province autonome di Trento e Bolzano sul documento recante "Piano Nazionale Prevenzione Vaccinale 2012-2104", febbraio 2012.

Pace D, Pollard AJ. Meningococcal disease: clinical presentation and sequelae. Vaccine. 2012;30S:B3–B9.

Strelow VL, Vidal JE. Invasive meningococcal disease. Arq Neuropsiquiatr. 2013;71:653–658.

Pollard AJ, Perrett KP, Beverley PC. Maintaining protection against invasive bacteria with protein-polysaccharide conjugate vaccines. Nature Reviews. 2009;9:213–220.

Zahlanie YC, Hammadi MM, Ghanem ST, et al. Review of meningococcal vaccines with updates on immunization in adults. Hum Vaccin Immunother. 2014;10:995–1007.

Hedari CP, Khinkarly RW, Dbaibo GS. Meningococcal serogroups A, C, W-135, and Y tetanus toxoid conjugate vaccine: a new conjugate vaccine against invasive meningococcal disease. Infect Drug Resist. 2014;7:85–99.

Snape MD, Kelly DF, Salt P, et al. Serogroup C meningococcal glycoconjugate vaccine in adolescents: persistence of bactericidal antibodies and kinetics of the immun eresponse to a booster vaccine more than 3 years after immunization. Clin Infect Dis. 2006;43:1387–1394.

Whalley PC, Snape MD, Kelly DF, et al. Persistence of serum bactericidal antibody one year after a booster dose of either a glycoconjugate or a plain polysaccharide vaccine against serogroup C Neisseria meningitidis given to adolescents previously immunized with a glycoconjugate vaccine. Pediatr Infect Dis J. 2011;30:e203–e208.

Chang Q, Tzeng YL, Stephens DS. Meningococcal disease; changes in epidemiology and prevention. Clin Epidemiol. 2012;4:237–245.

Bettinger JA, Scheifele DW, Le Saux N, et al. The disease burden of invasive meningococcal serogroup B disease in Canada. Pediatr Infect Dis J. 2013;32:e20–e25.

Panatto D, Amicizia D, Lai PL, et al. New versus old meningococcal group B vaccines: how the new ones may benefit infants & toddlers. Indian J Med Res. 2013;138:835–846.

Snape MD, Pollard AJ. The beginning of the end for serogroup B meningococcus? Lancet. 2013;381:785–787.

Holst J, Martin D, Arnold R, et al. Properties and clinical performance of vaccines containing outer membrane vesicles from Neisseria meningitidis. Vaccine. 2009;27(S2):B3–B12.

Holst J, Oster P, Ranold R, et al. Vaccines against meningococcal serogroup B disease containing outer membrane vesicles (OMV). Lessons from the past programs and implications for the future. Hum Vaccin Immunother. 2013;9:1241–1253. 24. O'Ryan M, Stoddard J, Toneatto D, et al. A multi-component meningococcal serogroup B vaccine (4CMenB): the clinical development program. Drugs. 2014;74:15–30.

Andrews SM, Pollard AJ. A vaccine against serogroup B Neisseria meningitidis: dealing with uncertainty. Lancet Infect Dis. 2014;14:426–434.

CDC. Meningococcal disease, Serogroup B meningococcal vaccine and outbreaks. su: www.cdc.gov/meningococcal/outbreaks/vaccine-serogroupB.html ( last access June 2014).

Major M, Moss S, Gold R. From genes to vaccine: a breakthrough in the prevention of meningococcal group B disease. Paediatr Child Haelth. 2011;16:e61–e64.

CDC. Princeton University meningococcal disease outbreak. su: www.cdc.gov/meningococcal/outbreaks/princeton.html (last access June 2014).

National Foundation for Infectious Diseases , author. Addressing the challenges of serogroup B meningococcal disease outbreaks on campuses: a report by the National Foundation fro Infectiuos Diseases. su: www.nfid.org/meningococcal-b (last access June 2014).

Novartis meningitis B vaccine Bexsero® receives FDA Breakthrough Therapy designation in the US [news release]. Basel, Switzerland: Novartis, April 7, 2014. su: www.novartis.com/newsroom/media-releases/en/2014/1774805.shtml. (last access June 2014).

CDC. University of California, Santa Barbara meningococcal disease outbreak. su: www.cdc.gov/meningococcal/outbreaks/ucsb.html (last access June 2014).

Kaaijk P, Ende A, Luytjes W. Routine vaccination against MenB. Considerations for implementation. Hum Vaccin Immunother. 2014;10:310–316.

Regione Basilicata. Dipartimento Politiche per la Persona. Deliberazione n. 167 dell'11 febbraio 2014. Approvazione del documento tecnico.-scientifico dal titolo "Programma di campagna vaccinale per la prevenzione primaria della malattia invasiva da Meningococco di gruppo B". su: http://opendata.regione.basilicata.it/opendata/home.jsp?tile=DELIBERE.delibere.jsp&numAtto=167&oggetto=&year=2014 (last access June 2014).

Regione Puglia. deliberazione della Giunta regionale n. 958 del 20 Maggio 2014. Commissione Regionale Vaccini. Modifica Calendario per la Vita 2012- DGR 241/2013. Approvazione nuovo Calendario Vaccinale per la vita 2014. su: http://www.regione.puglia.it/index.php?page=delibere&opz=view&id=12256) (last access June 2014).

Midthun K. FDA is working closely with manufacturers of meningitis B vaccines. su: http://blogs.fda.gov/fdavoice/?s=bexsero ( last access 2014).