Vaccine prevention of meningococcal disease in adolescents and travellers

Abstract

Invasive meningococcal disease (IMD) is endemic worldwide. Adolescence and travel to regions with hyper-endemic or epidemic disease are associated with a higher risk of IMD. Unpredictable variation in the serogroup distribution of Neisseria meningitidis over time and between different geographical areas is characteristic of the epidemiology of IMD. Currently serogroups B and C are most prevalent in Europe and in the US, where serogroup Y has also become a major cause of IMD over the last 20 years. In Asia, serogroups A and C predominate whilst serogroups A and W-135, and more recently X, have caused outbreaks in countries in the meningitis belt of sub-Saharan Africa. Despite appropriate and timely management, meningococcal meningitis and septicaemia are associated with an overall mortality of 8–14% and with permanent disabilities, such as amputations, hearing loss and neuro-developmental impairment in 10–19% of survivors. Vaccination remains the most effective strategy for preventing IMD in at risk individuals.