Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Neisseria meningitidis and meningococcal disease

recent discoveries and innovations

Read, Robert C.a,b

Current Opinion in Infectious Diseases: December 2019 - Volume 32 - Issue 6 - p 601–608
doi: 10.1097/QCO.0000000000000606
GRAM-NEGATIVE INFECTIONS: Edited by Matteo Bassetti
Buy

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.

aSchool of Clinical and Experimental Sciences and Institute for Life Sciences, University of Southampton

bNIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK

Correspondence to Robert C. Read, School of Clinical and Experimental Sciences and Institute for Life Sciences, University of Southampton; NIHR Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, UK. Tel: +00 44 02381204575; e-mail: r.c.read@soton.ac.uk

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.