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Meningococcal vaccines

Author
Michael Apicella, MD
Section Editors
Stephen B Calderwood, MD
Sheldon L Kaplan, MD
Deputy Editor
Elinor L Baron, MD, DTMH

INTRODUCTION

Meningococcal disease, especially meningococcal meningitis, is one of the most devastating infections for an individual or community; reports of documented or suspected cases can engender considerable panic, even among well-informed hospital personnel. Part of the explanation for this phenomenon is the fact that meningitis due to Neisseria meningitidis tends to strike young, previously well individuals and can progress over a matter of hours to death.

Mortality can be very high if the infection is not treated appropriately, and long-term sequelae can be severe even in successfully managed cases. The mortality and morbidity from meningococcal disease has changed very little since the 1950s, due principally to the inability to effectively manage the endotoxin-induced vascular collapse frequently caused by this organism.

Issues related to meningococcal vaccination will be reviewed here. The microbiology, pathobiology, epidemiology, clinical features, diagnosis, treatment, and prevention of meningococcal infections are discussed separately. (See "Microbiology and pathobiology of Neisseria meningitidis" and "Epidemiology of Neisseria meningitidis infection" and "Clinical manifestations of meningococcal infection" and "Diagnosis of meningococcal infection" and "Treatment and prevention of meningococcal infection".)

EPIDEMIOLOGY

The epidemiology of meningococcal infection is reviewed in detail separately. The following discussion will provide a summary that provides the rationale for meningococcal vaccination in selected individuals. (See "Epidemiology of Neisseria meningitidis infection".)

N. meningitidis can cause both endemic and epidemic infection. Meningococcal infections are endemic in the United States, and the annual incidence of invasive meningococcal disease varies in multiyear cycles; the most recent peak in incidence occurred during the mid-1990s (figure 1) [1]. Between 2005 and 2011, the incidence of meningococcal disease in the United States was 0.3 cases per 100,000 population [2]. Disease rates are almost 10 times higher in children below two years of age than in the overall population. (See "Epidemiology of Neisseria meningitidis infection", section on 'United States'.)

                                           

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