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PubMed2006

Modeling future changes to the meningococcal serogroup C conjugate (MCC) vaccine program in England and Wales.

The UK meningococcal serogroup C conjugate (MCC) vaccine program has successfully controlled serogroup C disease, due to high vaccine effectiveness and substantial herd immunity. However, children immunised at 2, 3 and 4 months of age receive only short-term direct protection and may be at risk of disease 15 months after vaccination. To investigate this we applied a mathematical model to predict the future epidemiology of serogroup C disease, with and without changes to the immunization schedule. Only a few cases of serogroup C disease were predicted to occur over the next few years because of persisting herd immunity, even without a change to the vaccine schedule. The inclusion of a booster dose is likely to improve the impact of the MCC program and reducing the number of doses in infancy will improve cost-effectiveness and create space in the schedule for the addition of other vaccines.

Adolescent↗
PubMed2006

Reactogenicity of meningococcal C conjugate vaccines when administered at the same time as, or a month prior to or after, tetanus and diphtheria booster vaccinations.

INTRODUCTION: This single blind study was conducted to address safety concerns regarding coadministration of diphtheria/ tetanus (DT,Td) boosters and meningococcal C conjugate (MCC) vaccines containing diphtheria or tetanus conjugate proteins. METHODS: 1754 subjects (835 preschoolers and 919 school leavers) were randomised to receive one of three MCC products a month before, after or at the same as routine DT or Td boosters. They (or their parents) completed a health diary for 10 days to record local reactions and systemic symptoms after each vaccination. The effect of antibody levels pre and post-vaccination, preexisting allergies and medication taken before and for up to ten days after vaccination on reactogenicity was assessed. RESULTS: No relationship between prevaccination antibody levels and local reactions or systemic symptoms was found. Local reactions were more common after DT/Td than MCC vaccination and were related to post-vaccination diphtheria and tetanus antibody levels in younger children and to the post-vaccination tetanus only antibody levels in older children. Preexisting allergies were not related to reactogenicity. Use of analgesics/antipyretic medication significantly reduced the incidence of local reactions and of some systemic symptoms. In the first three days after vaccination there was an excess of some systemic symptoms including fatigue/malaise and headache for all ages, and crying/ irritability for younger children and nausea/vomiting and dizziness/faintness for older subjects. Eleven serious adverse events were reported, none of which was deemed related to vaccination. CONCLUSION: MCC vaccines can be given under the above schedules and safely in the presence of raised diphtheria and tetanus antibody levels without materially altering reactogenicity profiles of either vaccine.

Adolescent↗
PubMed1982

Epidemiologic comparisons of incidence of toxic shock syndrome.

Despite many imperfections in the nationwide reporting of toxic shock syndrome, the available data provide some useful information. The crude toxic shock morbidity rate has been estimated as approximately 0.50 per 100 000 United States population per year. This morbidity rate exceeds those for paralytic poliomyelitis, tetanus, tularemia, diphtheria, and typhoid fever, and is about one half of the rate for meningococcal infections and pertussis. The estimate of 8.9 cases of toxic shock syndrome per 100 000 menstruating women is similar to the crude rates for primary and secondary syphilis and mumps. From these comparisons, the incidence of toxic shock syndrome does not appear as low as some might suppose.

Epidemiologic Methods↗
PubMed2001

Group C meningococcal vaccine trial: safety, immunogenicity and parents' views of participation.

In 1995, the Oxford Vaccine Group evaluated the safety and immunogenicity of a Group C meningococcal conjugate vaccine in 182 infants using the UK vaccination schedule. During and after the study we sought the views of parents about the vaccine and about their participation in the trial. The vaccine was well tolerated and resulted in fewer local reactions than the routine vaccinations, with no increase in systemic reactions. Post-vaccination antibody levels increased progressively after each dose of conjugate vaccine. We concluded that this meningococcal C conjugate vaccine is safe and immunogenic. The research process and the views of parents provide important lessons for researchers undertaking trials on infants.

Double-Blind Method↗
PubMed1976

[Basic trends and perspectives of development of Soviet pathological anatomy of childhood diseases].

The article deals with the main trends in scientific investigations in the field of pathological anatomy of diseases of childhood in the USSR. New data are presented on respiratory infectious diseases in children, pneumonias, serum hepatitis, meningococcal infection, immunodeficit states, nephrology, gastroenterology, pathology of therapy of tumours and leukemias, perinatal pathology. The main trends of further research in the field of infectious pathology, immunopathology, lesions of the central nervous system and the microcirculatory bed in children, tissue defects and diseases in fetus associated with late toxemia in mothers are suggested.

Central Nervous System Diseases↗
PubMedDate not supplied

[The prospects for the diagnosis of bacterial meningitis].

The samples of spinal fluid arriving to the Clinical Infectious Hospital in 1994-1996 with the clinical diagnosis "generalized form of meningococcal infection" or "purulent meningitis of unclear etiology" were studied. The etiological agent was bacteriologically identified in 35% of 487 patients (in 25% of cases Neisseria meningitidis, in 7% of cases Streptococcus pneumoniae and in 2% of cases Haemophilus influenzae, type b, were detected). The method of latex agglutination, used in this study, was highly specific (100%) and moderately sensitive (67%); this method made it possible to diagnose 25% of cases additionally (N. meningitidis in 15% of cases, S. pneumoniae in 5% of cases and H. influenzae in 3% of cases). Diagnostics with the use of PCR was characterized by high specificity (> 97%) and sensitivity (> 85%) relatively to the "golden standard" of microbiological diagnostics. There were few false positive results (3 samples), caused probably by contamination at the moment of taking the samples. For this reason the results obtained by PCR could be used for diagnostic purposes even in cases of negative results given by other methods. Tests with the use of PCR made it possible to diagnose 29% more cases additionally (in 26% of cases N. meningitidis DNA and in 3% of cases S. pneumoniae DNA were detected. Thus the complex of methods used in this study permitted the detection of the etiological agent altogether in 87% of cases.

Antigens, Bacterial↗
PubMed2000

[Multilocus sequencing--a new method of genotyping bacteria and first results of its use].

Comparative characterization (molecular typing) of isolates within a bacterial species is one of the major problems in microbiology and epidemiology. However, it is rather difficult to correlate data obtained in various laboratories, because traditional, including molecular, methods employed in typing pathogenic microorganisms cannot be standardized. In 1998, Maiden et al. proposed multilocus sequence typing (MLST); through which alleles of several housekeeping genes are directly assessed by nucleotide sequencing, each unique allele combination determining a sequence type of a strain. The advantages of this approach are that the culturing of pathogenic microorganisms is avoided, as their gene fragments are amplified directly from biological samples, and that the sequencing data are unambiguous, easy to standardize, and electronically portable. The latter makes it possible to generate an expandable global database for each species at an Internet site, in order to use it for the purposes of genotyping pathogenic bacteria (and other infectious agents). MLST protocols have been elaborated for Neisseria meningitidis, Streptococcus pneumoniae, and Helicobacter pylori; those for Streptococcus pyogenes, Staphylococcus aureus, and Haemophilus influenzae are now being developed. Basic principles and the first results of MLST have been reviewed, including data on the distribution and microevolution of N. meningitidis clones causing epidemic meningococcal infection, the relative recombination and mutation rates in the N. meningitidis genome, the identification of antibiotic-resistant S. pneumoniae clones causing severe generalized infection, the grouping of H. pylori isolates from various geographic regions, etc.

Bacteria↗
PubMedDate not supplied

[VA-MENGOC-BC vaccine: its impact on meningococcal disease in children 1-4 years old].

VA-MENGOC-BC vaccine has been administered to Cuban infants since 1991 through the National Immunization Program (NIP) so it was necessary to evaluate its effects on 1-4 years-old children included in the highest risk group. To this end, a descriptive study of the morbidity and mortality from meningococal disease was carried out taking the vaccine histories of 145 cases occurred from 1991 to 1996 into account. The decreasing trend of the incidence density (ID) of meningococcal disease in all the age groups in the studied period was among the most important results, the highest decline was observed in one-year old infants with an ID of. 10.8 per 100,000 children/years at the end of the period. The percent distribution of occurrence showed a predominance of one-year old group at the beginning of the program. Implementation, and a change to 3-4 years old group at the end of the period. A high of percent of vaccinated sick children had been immunized against MD over one year ago (697.5 days as average). 35 children died during the period and the highest mortality density decline (1 per 100,000 children a year) was observed as of 1993; 2 years-old children were at highest risk of death. Seventy three percent (73.1%) of those vaccinated had been immunized for over once year. The general lethality was 24.1%, the lowest was 14.3% in one year old children. The changes occurred in meningococcal disease behaviour within this high risk group, which are attributed to the administration of vaccine as part of the NIP fully justifies the continuation of the application of this vaccine.

Bacterial Vaccines↗