MENINGOCOCCAL DISEASE IN CHILDHOOD: EPIDEMIOLOGY, CLINICAL FEATURES AND PREVENTION
PDF

Keywords

children
invasive meningococcal disease
meningococcal disease
pediatric age
Neisseria meningitidis.

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.

https://doi.org/10.15167/2421-4248/jpmh2015.56.3.498
PDF

References

Khatami A, Pollard AJ. The epidemiology of meningococcal disease and the impact of vaccines. Expert Rev Vaccines 2010;9(3):285-298. Available from: http://www.tandfonline.com/doi/full/10.1586/erv.10.3 PubMed PMID: 20218857. doi: 10.1586/erv.10.3. [Google Scholar]

Harrison LH. Epidemiological profile of meningococcal disease in the United States.. Clin Infect Dis 2010 Mar;50 Suppl 2. Available from: http://www.cid.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=20144015 PubMed PMID: 20144015. doi: 10.1086/648963. [Google Scholar]

Dwilow R, Fanella S. Invasive meningococcal disease in the 21st century-an update for the clinicians. Curr Neurol Neurosci Rep 2015;15(3):2. Available from: http://link.springer.com/10.1007/s11910-015-0524-6 doi: 10.1007/s11910-015-0524-6. [Google Scholar]

Halperin SA, Bettinger JA, Greenwood B, Harrison LH, Jelfs J, Ladhani SN, et al. The changing and dynamic epidemiology of meningococcal disease.. Vaccine 2011 Dec;30 Suppl 2. Available from: https://www.nlm.nih.gov/medlineplus/meningococcalinfections.html PubMed PMID: 22178525. doi: 10.1016/j.vaccine.2011.12.032. [Google Scholar]

Esposito S, Principi N. Vaccine profile of 4CMenB: a four-component Neisseria meningitidis serogroup B vaccine.. Expert Rev Vaccines 2014 Jan;13(2):193-202. Available from: http://www.diseaseinfosearch.org/result/5121 PubMed PMID: 24393061. doi: 10.1586/14760584.2014.874949. [Google Scholar]

Christensen H, May M, Bowen L, Hickman M, Trotter CL. Meningococcal carriage by age: a systematic review and meta-analysis. Lancet Infect Dis 2010;10(12):853-861. Available from: http://www.scholaruniverse.com/ncbi-linkout?id=21075057 PubMed PMID: 21075057. doi: 10.1016/S1473-3099(10)70251-6. [Google Scholar]

Funk A, Uadiale K, Kamau C, et al. Sequential outbreaks due to new strain of Neisseria Meningitidis Serogroup C in Northern Nigeria, 2013-2014. PLOS Currents Outbreaks 2014;6. Available from. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25685621 [Google Scholar]

Xie O, Pollard AJ, Mueller JE, Norheim G. Emergence of serogroup X meningococcal disease in Africa: need for a vaccine.. Vaccine 2013;31(27):2852-2861. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0264410X13004751 PubMed PMID: 23623866. doi: 10.1016/j.vaccine.2013.04.036. [Google Scholar]

Törös B, Thulin Hedberg S, , Jacobsson S, et al. Surveillance of invasive Neisseria meningitidis with a serogroup Y update, Sweden 2010 to 2012. Euro Surveill 2014;19 pii 20940. Available from. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25358044 [Google Scholar]

Branco RG, Tasker RC. Meningococcal meningitis.. Curr Treat Options Neurol 2010;12(5):464-474. Available from: http://link.springer.com/10.1007/s11940-010-0086-5 PubMed PMID: 20842601. doi: 10.1007/s11940-010-0086-5. [Google Scholar]

Sabatini C, Bosis S, Semino M, Senatore L, Principi N, Esposito S. Clinical presentation of meningococcal disease in childhood.. J Prev Med Hyg 2012;53(2):116-119. Available from: https://www.nlm.nih.gov/medlineplus/meningococcalinfections.html PubMed PMID: 23240173. [Google Scholar]

Dass Hazarika R, Deka NM, Khyriem AB, Lyngdoh WV, Barman H, Duwarah SG, et al. Invasive meningococcal infection: analysis of 110 cases from a tertiary care centre in North East India.. Indian J Pediatr 2012 Jul;80(5):359-364. Available from: http://www.diseaseinfosearch.org/result/4598 PubMed PMID: 22821284. doi: 10.1007/s12098-012-0855-0. [Google Scholar]

Sadarangani M, Scheifele DW, Halperin SA, et al. Investigators of the Canadian Immunization Monitoring Program, ACTive (IMPACT) , investigator. Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: a prospective cohort study. Clin Infect Dis. 2015;60:e27–e35. Available from:http://www.ncbi.nlm.nih.gov/pubmed/25605282 PubMed PMID: 25605282

Stein-Zamir C, Shoob H, Sokolov I, Kunbar A, Abramson N, Zimmerman D. The clinical features and long-term sequelae of invasive meningococcal disease in children.. Pediatr Infect Dis J 2014;33(7):777-779. Available from: https://www.nlm.nih.gov/medlineplus/learningdisorders.html PubMed PMID: 24622347. doi: 10.1097/INF.0000000000000282. [Google Scholar]

Wang B, Clarke M, Thomas N, Howell S, Afzali HHA, Marshall H. The clinical burden and predictors of sequelae following invasive meningococcal disease in Australian children.. Pediatr Infect Dis J 2014;33(3):316-318. Available from: https://www.nlm.nih.gov/medlineplus/meningococcalinfections.html PubMed PMID: 24030352. doi: 10.1097/INF.0000000000000043. [Google Scholar]

Borrow R, Abad R, Trotter C, van der Klis, R.M. (Fiona) , Vazquez JA. Effectiveness of meningococcal serogroup C vaccine programmes. Vaccine 2013;31(41):4477-4486. Available from: https://www.nlm.nih.gov/medlineplus/immunization.html PubMed PMID: 23933336. doi: 10.1016/j.vaccine.2013.07.083. [Google Scholar]

Read RC, Baxter D, Chadwick DR, Faust SN, Finn A, Gordon SB, et al. Effect of a quadrivalent meningococcal ACWY glycoconjugate or a serogroup B meningococcal vaccine on meningococcal carriage: an observer-blind, phase 3 randomised clinical trial.. Lancet 2014;384(9960):2123-2131. Available from: http://ClinicalTrials.gov/search/term=25145775%20%5BPUBMED-IDS%5D PubMed PMID: 25145775. doi: 10.1016/S0140-6736(14)60842-4. [Google Scholar]

Hedari CP, Khinkarly RW, Dbaibo GS. Menigococcal 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. [Google Scholar]

Lee HJ, Chung M, Kim WJ, Hong YJ, Choi KM, Lee J, et al. Immunogenicity and safety of a novel quadrivalent meningococcal conjugate vaccine (MenACWY-CRM) in healthy Korean adolescents and adults. Int J Infect Dis 2014;28:204-210. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1201-9712(14)01568-9 PubMed PMID: 25316331. doi: 10.1016/j.ijid.2014.06.008. [Google Scholar]

Vernikos G, Medini D. Bexsero® chronicle.. Pathog Glob Health 2014;108(7):305-316. Available from: http://europepmc.org/abstract/MED/25417906 PubMed PMID: 25417906. doi: 10.1179/2047773214Y.0000000162. [Google Scholar]

McNamara LA, Shumate AM, Johnsen P, MacNeil JR, Patel M, Bhavsar T, et al. First Use of a Serogroup B Meningococcal Vaccine in the US in Response to a University Outbreak.. Pediatrics 2015;135(5):798-804. Available from: https://www.nlm.nih.gov/medlineplus/meningococcalinfections.html PubMed PMID: 25917990. doi: 10.1542/peds.2014-4015. [Google Scholar]

Pfizer announces positive top-line results of a phase 2 study Of TRUMENBA® (meningococcal group B vaccine) co-Administered with routine meningococcal (A, C, Y, and W) and tetanus, diptheria and pertussis (Tdap) vaccines in adolescents. Available from: http://www.pfizer.com/news/press-release/press-release-detail/pfizer_announces_positive_top_line_results_of_a_phase_2_study_of_trumenba_meningococcal_group_b_vaccine_co_administered_with_routine_meningococcal_a_c_y_and_w_and_tetanus_diphtheria_and_pertussis_tdap_vaccines_in). Accessed on February 27, 2015.

Saez-Llorens X, Dc AV, Abarca K, et al. Immnogenicity and safety of investigational vaccine formulations against maningococcal serogroups A, B, C,W and Y in healthy adolescents. Hum Vaccin Immunother 2015;13 Available from. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25969894 [Google Scholar]

Tunheim G, Næss LM, Acevedo R, et al. Preclinical immunogenicity study of trivalent meningococcal AWX-OMV vaccines for the African meningitis belt. Vaccine. 2014;32:6631–6638