Meningococcal Vaccines

Prof. Mohammad Hossein Soltanzadeh,MD,

ID, prof. of Pediatrics , Shahid Beheshti                    

 University of Medical Science, Tehran , IRAN

 

The US Food & Drug Administration ( FDA ) has expanded the indication for the quadrivalent  meningococcal vaccine ( Menveo , Novartis ) to infants and toddlers from age 2 months , the company announced .

The vaccine protects against invasive disease caused by common Neisseria meningitides  serogroups A,C, Y , and W-135.

As previously reported , Menveno has been available for use in adolescents and adults ( 11-55 years of age since February 2010 ) and children ( 2-10 years of age since January 2011 ) .

With this expanded indication, “ we now have the opportunity to help protect our infants against 4 strains of meningococcal disease earlier , when they are most vulnerable “ he said .

Studies show that infants younger than 7 months are the age group most vulnerable to meningococcal disease in the United states . In their  first year of  life , infants are more than 7  times more likely to contract the disease than 14 to 24 year  olds . O f the infants who contract the disease , more than 10% will die from it , and of those who do  survive , roughly in 5 will suffer permanent  adverse effects.

The FDA,s  decision to expand use of the vaccine to infants from 2 months of age .

Menveo is currently registered in more than 50 countries for active immunization to prevent invasive meningococcal disease caused by N. meningitides serogroups A,C,W-135 , and Y , no vaccine is approved to protect against meningitis serogroup B infection.

Meningococcal Infections

Invasive infection usually results in meningogoccsemia , meningitis , or both , Onset oftens abrupt in meningococcemia , with fever , chills ,malaise , prostration, and a rash that initially can be macular, maculopapular , or petechial .The progression of disease often is rapid . In fulminant  cases (Waterhouse –Friderichsen syndrome ) , purpura , disseminated intravascular coagulation(DIC) , shock ,coma, and death can ensue despite appropriate therapy . The signs and symptoms are  the same of other meningitis.

Sequele  associated with meningococcal disease occur in 11 % to 19% of patients and include : hearing loss , neurologic disability , digit or limb amputations , and skin scaring , sometimes requiring skin gruafts.

Etiology

Neisseria   meningitidis  is gram – negative diplococcus with at least 13  serogroups.