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PubMed2000

Meningococcal disease and college students. Recommendations of the Advisory Committee on Immunization Practices (ACIP).

This report provides information regarding the modestly increased risk for meningococcal disease among college freshmen, particularly those who live in dormitories or residence halls. It presents recommendations developed by the Advisory Committee on Immunization Practices regarding the education of students and parents about meningococcal disease and the polysaccharide meningococcal vaccine so that they can make informed decisions regarding vaccination.

Adolescent↗
PubMedDate not supplied

Purpura fulminans in children: report of two cases.

Purpura fulminans, usually seen in previously healthy children acquiring severe infections, especially meningococcal sepsis and meningitis, is a rare catastrophic disease with initial hemorrhagic skin lesions rapidly progressing to gangrene accompanied by shock and frequently resulting in death. We report 2 cases of purpura fulminans who were diagnosed in the past 2 years. Both blood cultures yielded Neisseria meningitidis. One of them expired within 48 hours after admission despite aggressive therapy. The second patient, who received the treatment of heparin, antibiotics, and blood product replacement, survived with minimal sequelae. We deem young age and severe coagulopathy are especially associated with a fatal outcome in children with purpura fulminans. Early recognition of this disease and prompt appropriate therapy may be lifesaving for these patients.

Age of Onset↗
PubMed2000

[Susceptibility to antimicrobial drugs used in the prophylaxis of meningococcal disease: situation after an epidemic wave].

In the early 1990s a rise in the incidence of meningococcal disease was observed in Galicia, Spain, most cases of which were caused by serogroup C meningococcal strains. As part of the epidemiological analysis of this epidemic wave, two studies of asymptomatic carriers of neisseria meningitidis were carried out: the first took place during the period of maximum incidence and coincided with a massive immunization campaign (December 1996 to January 1997); and the second was conducted one year later (January 1998). A total of 1234 meningococcal strains were isolated in both studies (789 in the first and 445 in the second study) and the susceptibility to rifampin, ciprofloxacin, ceftriaxone and sulfadiazine was determined. The susceptibility to rifampin, ciprofloxacin and cetriaxone was high among the strains isolated in both studies. For sulfadiazine, the percentage of resistant strains was 92.6% for the first and 86.3% for the second study.

Adolescent↗
PubMedDate not supplied

[Results of a study on the under-detection of meningococcus in vaccinated subjects in Galicia].

BACKGROUND: On the basis of active surveillance and the monitoring of Meningococcal Disease (MD) following the vaccination campaign carried out in Galicia, it was observed that the proportion of isolations of the serogroups responsible for the disease among individuals suspected of Meningococcal Disease (SMD) who had been vaccinated was lower than among unvaccinated individuals. In view of this situation, a study was made in order to determine whether in the origin of those SMDs that were not isolated, we would find N. Meningitidis serogroup C, and to quantify the significance of the sub-detection of same. METHODS: For this purpose, and during the period under study (from the 26th week of 1997 to the 14th week of 1999), blood and cephalorachidian fluid samples were taken from the SMDs without isolation for their study with C protein reagent for type and serogroup. The analysis of the samples was performed by the microbiology laboratory of the Clinical Hospital of Santiago de Compostela. RESULTS: Of the 120 cases notified during the period under study, 65 were analysed by C protein reagent (38 vaccinated and 27 unvaccinated), with a positive reading for N. meningitidis in 65% (42 samples) 74% in vaccinated individuals and 52% in unvaccinated. By estimating, on the basis of the cases studied, the results for the total, and excluding the C protein reagent negative cases, we find that, for serogroup C, in only 27% of the cases occurring in vaccinated individuals was it possible to isolate it, in comparison with 80% in the case of unvaccinated subjects (p < 0.0001). These percentages are, in the case of serogroup B, 59% and 71%, respectively, a difference which is not statistically significant. CONCLUSIONS: The vaccine brought about an true sub-detection of serogroup C meningococci in the vaccinated cases.

Adolescent↗
PubMedDate not supplied

[Evolution of meningococcal disease in the community of Madrid. Effectiveness of antimeningococcal A+C vaccination].

BACKGROUND: In 1997 (between 22 September and 14 November) an A + C meningococcal mass vaccination campaign was carried out in Madrid, targeting the age group of from 18 months to 19 years of age, in the face of an increase in the number of cases of meningococcal disease caused by serogroup C occurring in the 1996-97 season. This study forms a part of the impact assessment of that campaign. METHODS: The evolution of the meningococcal disease, by means of the comparison of rates of incidence; and the efficacy of the vaccination campaign was determined after one year (1997-98 season) and after two years (1997-98 and 1998-99 seasons) of monitoring. The vaccine efficacy has been calculated as [1-(Incidence rate in vaccinated/Incidence rate in unvaccinated)]* 100. RESULTS: A significant drop was registered in the incidence of serogroup C meningococcal disease on comparing the 1997-98 and 1998-99 seasons with the epidemic season (1996-97). The vaccine efficacy after two years of monitoring subsequent to the vaccination campaign was 76.9% for the global population between 18 months and 19 years of age and 88.5% in the group of vaccinated individuals between 15 and 19 years of age. CONCLUSIONS: The vaccine efficacy obtained is compatible with that described in the relevant literature. The significant reduction in the incidence of meningococcal disease caused by serogroup C was due to the vaccine efficacy obtained.

Adolescent↗
PubMed2001

[Meningococcal disease. new prevention strategies].

Because conjugate C meningococcal vaccines represent a significant advance in the prevention of meningococcal disease, currently accepted recommendations on vaccination should be revised. The health authorities are responsible for carrying out national surveillance programs and for evaluating the need for vaccination programs. These programs should target all groups at risk for this disease and should confer adequate and lasting protection in vaccinated children.

Adolescent↗
PubMed2001

[Pharmacy clinics. Medication of the month. Meningitec].

Meningitec (Wyeth Lederle) is a new antimeningococcal C conjugate vaccine. This vaccine contains a group C meningococcal oligosaccharide coupled to a carrier protein (CRM197, a non toxic variant of diphteria toxoid). This vaccine has been shown to be immunogenic both in adults and young children. Meningitec is well tolerated and its efficacy has been recently demonstrated in England (vaccine efficacy: 97% among adolescents; 92% among toddlers).

Adolescent↗
PubMedDate not supplied

[Evaluation of the immunological activity and safety of group B meningococcal vaccine prepared from a natural complex of specific polysaccharide and outer membrane proteins].

Immunological activity and safety of group B meningococcal vaccine prepared from a natural complex of specific polysaccharide and outer membrane proteins were under study. The immunological safety of the vaccine was evaluated by the absence of antibodies to denaturated and native DNA (d-DNA and n-DNA). As shown with the use of the enzyme immunoassay (EIA), the administration of the vaccine did not induce antibody formation to d-DNA and n-DNA during the observation period. The titer of bactericidal antibodies in the immune bacteriolysis assay (IBA) to the vaccine strain B:2b:P1.2 after immunization increased four-fold and greater in 80% of the vaccinated persons. The significant increase of bactericidal antibodies to heterologous strains B:2a:P1.2 and B:15:P1.7 was registered in 20-30% of the vaccinees, respectively. A month after the repeated vaccination an increase in specific IgG antibodies to the complex antigen was found to occur according to EIA results. The use of RIB made it possible to evaluate the preventive activity of group B meningococcal vaccine as a whole and to suppose that the vaccine induced mainly type-specific response.

Adult↗