UMEM Educational Pearls

Title: Meningococcal Outbreaks and Vaccine Coverage

Keywords: meningoccocus, Neisseria meningitidis, global, infectious disease (PubMed Search)

Posted: 11/20/2013 by Andrea Tenner, MD (Updated: 11/22/2024)
Click here to contact Andrea Tenner, MD

General Information:

Nisseria meningitidis is the common culprit in epidemic meningitis. Serogroup B is currently causing an outbreak on the Princeton campus. So what are the serogroups and why are they important?

Six main serogroups cause disease: A, B, C, Y, X, W-135.

A: most common cause of meningitis in the Meningitis Belt in Sub-Saharan Africa, caused pandemics in the 1960s-1980s in Asia as well
B, C, Y: Cause the large majority of cases in Europe and the Americas
A, W-135: most common culprits in outbreaks of meningitis associated with the Hajj
X: causes disease in some countries in Sub-Saharan Africa

Two quadrivalent vaccines are currently licensed in the US that cover Serogroups A, C, Y, and W-135.

Relevance to the EM Physician: The currently available vaccines in the US cover the majority of serogroups of meningococcus, however, Serogroup B (currently causing an outbreak at Princeton) is not covered, nor is Serogroup X (for travelers to Sub-Saharan Africa).

Bottom Line: Serogroups B and X are not covered by the currently available vaccines in the US and at risk populations (and physicians treating those patients) should be made aware of the gap in coverage. Investigations for a vaccine for Serogroup B (licensed in Europe and Australia, but not in the US) are currently underway.

University of Maryland Section of Global Emergency Health

Author: Andi Tenner, MD, MPH, FACEP

References

Cohn A, MacNeil JR. Chapter 3: Infectious Diseases Related to Travel: Meningitis. Centers for Disease Control Yellow Book. 2014. Accessed at: http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/meningococcal-disease on 20 Nov 2013.

Harrison LH. The Epidemiology of Meningococcal Disease in the United States. Clin Infect Dis. 2010 March 1; 50(S2):S37.

Meningococcal Disease in Other Countries. Center for Disease Control. Accessed at: http://www.cdc.gov/meningococcal/global.html on 20 Nov 2013.

National Travel Health Network and Centre. Meningitis Fact Sheet. Accessed at: http://www.nathnac.org/pro/factsheets/meningococcal.htm on 20 Nov 2013.