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PubMed1997

Meningococcal disease: public health burden and control.

Meningococcal disease which is increasing globally is still associated with a high mortality and persistent neurological defects, particularly among infants and young children. Sporadic meningococcal meningitis occurs throughout the world, with seasonal variations, and accounts for 10-40% of endemic bacterial meningitis. Epidemic meningitis occurs in any part of the world but the largest and most frequently recurring epidemics have been in the semi-arid area of sub-Saharan Africa where the current pandemic is associated with attack rates exceeding 500 per 100,000 population and thousands of deaths. In the Americas and Europe serogroup B is the predominant agent causing systemic disease, followed in frequency by serogroup C. Serogroup A meningococcus was historically the main cause of epidemic meningococcal disease globally and still predominates in Africa and Asia. A range of internal and external factors predispose for epidemics such as strain virulence, carriers, humoral immunity, co-infections, low humidity and drought, population movements and crowding. To respond to the current situation and the expected spread of the disease, WHO, in collaboration with its Member States and various governmental and non-governmental agencies, has developed a sustainable plan of action for preparedness and control of meningitis.

Adolescent↗
PubMed2005

Cutaneous adverse reactions following anti-infective vaccinations.

Although widely administered, anti-infective vaccinations are rarely responsible for cutaneous adverse effects. In this context, hepatitis B and bacillus Calmette-Guerin vaccines are the most frequently incriminated products. Cutaneous adverse effects are less frequently encountered following administration of vaccines against varicella, diphtheria/tetanus/pertussis (primary and booster doses), measles, poliomyelitis, rubella, pneumococcus, tick-borne encephalitis, smallpox, Meningococcus and influenza. The adverse effects can occur at the site of or at a distance from the injection. The patho-mechanisms of local adverse cutaneous reactions include predominantly nonspecific lymphoid or granulomatous reactions. Allergic reactions to the vaccine strain, adjuvants, conservatives or other components are less frequently involved in local vaccine adverse effects. Systemic reactions are mainly mediated by immediate type or immune complex-related allergic reactions to toxoid-, ovalbumin-, gelatin- or pneumococcal-containing vaccines. Systemic reactions are sometimes related to a specific vaccine strain. Other cutaneous reactions may also occur through unknown patho-mechanisms. No vaccine type or strain is specifically associated with a particular type of cutaneous adverse effect. This article presents seven case reports of cutaneous adverse effects following anti-infective vaccination then reviews the relevant literature on this subject.

Adult↗
PubMed2006

Intranasal immunization of mice with recombinant lipidated P2086 protein reduces nasal colonization of group B Neisseria meningitidis.

Neisseria meningitidis is a major cause of bacterial meningitis in the human population, especially among young children. There is a need to develop a non-capsular vaccine to prevent meningococcal B infections due to the inadequate immune response elicited against the capsular polysaccharide of these strains. Previously, we developed a Swiss Webster adult mouse intranasal challenge model for group B N. meningitidis and evaluated several potential vaccine candidates including a meningococcal outer membrane protein, P2086, through parenteral immunization. Since N. meningitidis is a respiratory pathogen, a mucosal immune response may play an important role in the defense against meningococcal infections. Thus, intranasal immunization may be more effective than traditional parenteral immunization. In this study, mice were immunized intranasally with purified recombinant lipidated P2086 protein (rLP2086) adjuvanted with either CT-E29H, a genetically modified cholera toxin that is significantly reduced in enzymatic activity and toxicity or RC529-AF, a synthetic immunostimulant molecule in aqueous formulation. rLP2086-specific serum and mucosal IgG and IgA antibodies were induced. IgG antibodies reacted with whole cells of multiple strains of group B N.meningitidis. The antibodies have functional activity against N. meningitidis as demonstrated by bactericidal assays. Moreover, immunized mice exhibited reduced nasal colonization of group B meningococcal strains in the intranasal challenge model. These results demonstrate that an intranasal immunization with rLP2086 protein formulated with a detoxified cholera toxin or RC529-AF could prevent the initial colonization of group B meningococcus and become an effective immunization strategy against group B N. meningitidis.

Administration, Intranasal↗
PubMed2005

[Chronic meningococcemia].

INTRODUCTION: Chronic meningococcemia is a rare clinical form of invasive Neisseria meningitidis infection. We report 2 cases. OBSERVATIONS: A 39 year-old man and a 42 year-old woman had developed a widespread, fleeting and painful maculopapular cutaneous eruption over the past few weeks, associated with intermittent fever and inflammatory arthralgia. In both cases blood cultures isolated a serogroup B meningococcus that confirmed the diagnosis. Cutaneous histology revealed a non-specific image of leukocytoclastic vasculitis. Treatment with beta lactamin antibiotics was successful after respectively 3 weeks and 12 days. DISCUSSION: This septicemia is characterized by the clinical triad of cutaneous eruption, fever and arthralgia. It must not be mistaken for connectivitis because inappropriate corticosteroid prescription may provoke severe complications. Confirmation of the diagnosis is provided by the blood cultures, which should be repeated. In the case of strong clinical suspicion, the rapid improvement with antibiotics confirms the diagnosis.

Adult↗
PubMed1991

[Evaluation of the coagglutination reaction with urine in generalized forms of meningococcal infection].

The coagglutination test with concentrated urine was tried in 59 patients with validated generalized forms of meningococcal infection and in 23 ones with meningitides and pneumonia of a different etiology to assess the diagnostic value of this test. Positive results were obtained in 64.4% of the test group patient and in 4.3% of the reference patients (in a case with pneumococcal meningitis). The antigen serologic group in the urine coincided with the serologic group of the meningococcus that induced the disease in only 19 (50%) of the 38 patients in whom antigenuria+ was detected. In the rest cases urine samples reacted parallel with 2-7 antisera, in 5 patients with the antisera heterologic towards the serologic group of the meningococcus responsible for the disease. Antigenuria was observed between the second and ninth days of the illness, its peak was recorded on days 4-6. Repeated urine tests are more likely to yield positive results. The authors come to a conclusion that the test is simple and harmless for patients, but the presence of false positive results permits regarding it as but an auxiliary one.

Agglutination Tests↗
PubMed1993

Protective immunity in baboons vaccinated with a recombinant antigen or radiation-attenuated cercariae of Schistosoma mansoni is antibody-dependent.

Mice vaccinated with radiation-attenuated cercariae of Schistosoma mansoni exhibit high levels of resistance to challenge infection. We have previously shown that sera from these mice recognize polypeptides that are expressed on the surface of newly transformed schistosomula. We have cloned and sequenced a cDNA that encodes a 62-kDa portion of one of these polypeptides. Vaccination of mice with this 62-kDa polypeptide (designated rlrV-5) elicits high antibody titers and significant resistance to challenge infection. We report here the results of a vaccination trial in baboons with the rlrV-5 or radiation-attenuated cercariae. rlrV-5 was presented either in the form of protein micelles or complexed with the outer membrane protein of meningococcus to form proteosomes. The level of protection achieved in these groups ranged from 0 to 54%, with a mean of 27.7%. In baboons exposed to radiation-attenuated cercariae the level of protection was very high, with a mean of 84%. The resistance observed after vaccination with rlrV-5 or radiation-attenuated cercariae was reflected in the overall histopathology. Vaccination of baboons with rlrV-5 or radiation-attenuated cercariae elicited an antibody response against epitopes exposed on the surface of newly transformed schistosomula. In the case of baboons vaccinated with radiation-attenuated cercariae, this response was not limited to epitopes encompassed by rlrV-5. Analysis of individual baboon sera by ELISA demonstrated that there was a direct correlation between the anti-rlrV-5 titer and resistance to challenge worm burden, suggesting that the immunoprotective mechanism is antibody-dependent.

Animals↗
PubMed1979

Urethritis attributable to Neisseria meningitidis, group X: a case report.

Neisseria meningitidis, Group X, was recovered from the anterior urethra of a 27-year-old male patient with urethritis. This isolate represents the first reported recovery of this organism from this anatomic site in association with this disease. He was treated with probenicid by mouth, followed by 4.8 million units of aqueous procaine penicillin G injected intramuscularly and became asymptomatic in three days. His recovery strongly indicates that the meningococcus was the etiologic agent of the urethritis since the condition promptly cleared with penicillin therapy.

Adult↗
PubMed1978

[Epidemiological evaluation of the serological grouping of meningococci].

Use of the precipitation and hemagglutination inhibition tests to determine the serological group of 114 meningococcus strains which cannot be grouped by agglutination slide permitted to establish the serological group of 56% of the strains, this pointing to the greater diagnostic value of these tests. Nevertheless, 70% of 307 strains isolated from carriers could not be referred to any of the determinable groups (A, C, X, Y, and Z). Strains (417) isolated from the cerebrospinal fluid of patients with meningitis were grouped depending on the epidemic curve: only half of the cultures could be classified in sporadic cases, but from 80 to 100% of the strains were classified at the "peak" of the meningitis incidence rise. This rise was connected with increase of the incidence of cases caused by meningococcus, group A; at the decline these strains were eliminated, and cases due to the rarely encountered serological groups and nongrouping strains occurred. Marking meningococc by serological groups proved to be of no use for detection of epidemiological relations between the infected persons.

Agglutination Tests↗
PubMed1978

[Hyaluronidase in meningococcus].

A total of 204 meningococcus strains were tested for the presence of hyaluronidase, and 45.5% of the strains were found to contain it. Strains penetrating into the cerebrospinal fluid were the ones which largely produced the enzyme (in 83% of the cases). The enzyme was revealed only in 25.5% of the strains habituating on the nasopharyngeal mucosa. Hyaluronidase was mostly found in the meningococcus strains referred to the serological group A; strains of other serological groups and ungrouped strains produced the enzyme in 23.7% of the case only. There was no correlation between the capacity to form hyaluronidase and the virulence determinable in intraperitoneal infection of mice.

Hyaluronoglucosaminidase↗
PubMed2005

Multilocus sequence typing of Neisseria meningitidis directly from clinical samples and application of the method to the investigation of meningococcal disease case clusters.

Infections associated with Neisseria meningitidis are a major public health problem in England, Wales, and Northern Ireland. Currently, over 40% of cases are confirmed directly from clinical specimens using PCR-based methodologies without an organism being isolated. A nested/seminested multilocus sequence typing (MLST) system was developed at the Health Protection Agency Meningococcal Reference Unit to allow strain characterization beyond the serogroup for cases confirmed by PCR only. This system was evaluated on a panel of 20 meningococcus-positive clinical specimens (3 cerebrospinal fluid and 17 blood samples) from different patients containing various concentrations of meningococcal DNA that had corresponding N. meningitidis isolates. In each case, the sequence type generated from the clinical specimens matched that produced from the corresponding N. meningitidis isolate; the sensitivity of the MLST system was determined to be less than 12 genome copies per PCR. The MLST system was then applied to 15 PCR meningococcus-positive specimens (2 cerebrospinal fluid and 13 blood samples), each from a different patient, involved in three case clusters (two serogroup B and one serogroup W135) for which no corresponding N. meningitidis organisms had been isolated. In each case, an MLST sequence type was generated, allowing the accurate assignment of individual cases within each of the case clusters. In summary, the adaptation of the N. meningitidis MLST to a sensitive nested/seminested format for strain characterization directly from clinical specimens provides an important tool for surveillance and management of meningococcal infection.

Bacterial Proteins↗