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Neisseria meningitidis and meningococcal disease: recent discoveries and innovations

Neisseria meningitidis and meningococcal disease: recent discoveries and innovations
Neisseria meningitidis and meningococcal disease: recent discoveries and innovations

PURPOSE OF REVIEW: Meningococcal disease is a severe consequence of infection with Neisseria meningitidis, a pathobiont of the pharynx. This organism is panmitic so virulent clones transformed with new genetic material can emerge and cause severe outbreaks. The key to sustainable prevention is to restrict carriage of disease-causing strains and thus reduce the chances of transmission between human hosts.

RECENT FINDINGS: Meningococcal population biology has changed recently with emergence of virulent strains linked to a number of sublineages of clonal complex 11. These strains have variously expressed the capsular material of serogroups C and W and caused severe disease in various countries. Glycoconjugate vaccines including quadrivalent (ACWY) and now pentavalent (ACWYX) vaccines are highly immunogenic and prevent disease and carriage due to their respective serogroups. For NmB, new vaccines (4CMenB and MenB-FHbp) containing conserved outer membranes proteins have been deployed and are immunogenic and protective at population level, but clones exist which do not express cognate antigens. In contrast to glycoconjugate vaccines they may not have potent carriage-reducing activity. Mass chemoprophylaxis is gaining credence as an alternative strategy is effective, but has significant shortcomings in sustainability.

SUMMARY: Meningococcal disease is well defined genomically for epidemiological purposes. There is potential for unpredictable emergence of clones that may have reduced susceptibility even to modern vaccines, and continued surveillance and vigilance is necessary. However, tremendous strides have been made in recent years.

0951-7375
601-608
Read, Robert C
b5caca7b-0063-438a-b703-7ecbb6fc2b51
Read, Robert C
b5caca7b-0063-438a-b703-7ecbb6fc2b51

Read, Robert C (2019) Neisseria meningitidis and meningococcal disease: recent discoveries and innovations. Current Opinion in Infectious Diseases, 32 (6), 601-608. (doi:10.1097/QCO.0000000000000606).

Record type: Review

Abstract

PURPOSE OF REVIEW: Meningococcal disease is a severe consequence of infection with Neisseria meningitidis, a pathobiont of the pharynx. This organism is panmitic so virulent clones transformed with new genetic material can emerge and cause severe outbreaks. The key to sustainable prevention is to restrict carriage of disease-causing strains and thus reduce the chances of transmission between human hosts.

RECENT FINDINGS: Meningococcal population biology has changed recently with emergence of virulent strains linked to a number of sublineages of clonal complex 11. These strains have variously expressed the capsular material of serogroups C and W and caused severe disease in various countries. Glycoconjugate vaccines including quadrivalent (ACWY) and now pentavalent (ACWYX) vaccines are highly immunogenic and prevent disease and carriage due to their respective serogroups. For NmB, new vaccines (4CMenB and MenB-FHbp) containing conserved outer membranes proteins have been deployed and are immunogenic and protective at population level, but clones exist which do not express cognate antigens. In contrast to glycoconjugate vaccines they may not have potent carriage-reducing activity. Mass chemoprophylaxis is gaining credence as an alternative strategy is effective, but has significant shortcomings in sustainability.

SUMMARY: Meningococcal disease is well defined genomically for epidemiological purposes. There is potential for unpredictable emergence of clones that may have reduced susceptibility even to modern vaccines, and continued surveillance and vigilance is necessary. However, tremendous strides have been made in recent years.

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Published date: December 2019

Identifiers

Local EPrints ID: 438853
URI: http://eprints.soton.ac.uk/id/eprint/438853
ISSN: 0951-7375
PURE UUID: 907c4fbd-a893-419a-9dd2-ded9a800a8d8
ORCID for Robert C Read: ORCID iD orcid.org/0000-0002-4297-6728

Catalogue record

Date deposited: 25 Mar 2020 17:31
Last modified: 18 Feb 2021 17:18

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