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Abstract
Meningococcal Disease, manifesting as meningitis and septicemia, is a life-threatening bacterial infection that results in significant morbidity and mortality, particularly in childhood. Its epidemic potential and limited opportunities for clinical intervention due to its rapid course present unique public health and clinical challenges. Incidence is highest in infants and young children, with a secondary peak of risk in adolescents. Approximately 10% of cases are fatal and survivors can be left with serious and permanent sequelae including amputations, hearing loss and cognitive impairment. Transmission is only from human-to-human, by infected respiratory tract secretions or saliva and therefore crowding poses a tremendously elevated risk for disease development. Military recruits and university students are at high risk due to the high carriage rate in adolescents, their behavior patterns and close contact. Menveo® (Novartis Vaccines and Diagnostics), a novel quadrivalent meningococcal conjugate vaccine directed against meningococcal serogroups A, C, W-135 and Y, has been shown to be immunogenic and well tolerated in all age groups and was recently licensed for use in Korea. Recent cases and deaths among military recruits drew public attention to their elevated risk and the Korean government has recommended vaccination of all new military recruits. Many Korean students seek to attend school, university, or language institutes in countries where routine meningococcal vaccination is required - clinicians should be aware of such requirements to ensure that students are vaccinated prior to arrival in the destination country.
Figures and Tables
Fig. 3
Comparison of immunogenicity of MenACWY-CRM with that of MenACWY-D per serogroup, one month post-vaccination.
Fig. 4
Immunogenicity of MenACWY-CRM compared with placebo in Korean adolescents and adults, by serogroup, one month post-vaccination.
Fig. 5
Korean Educational Development Institute survey of Korean students traveling internationally for courses of study, by purpose of study and destination country, 2011.
Table 1
Psychometric Testing in Recovered Cases of Serogroup B Meningococcal Disease
Note: Data are mean scores, unless otherwise stated. IQ, intelligence quotient.
*Wechsler pre-school and primary scale of intelligence (WPPSI) for participants aged 3-6 years, or the – Wechsler abbreviated scale of intelligence (WASI) for those aged 7 years or older.
†Children's Memory Scale, for participants aged 5 years or older and Rey Osterreith complex figure test for those aged 6 years or older.
‡Parental completion of the Strengths and Difficulties questionnaire (all ages).
Table 2
Serogroup Distributions of N. Meningitidis in Cerebrospinal Fluid (CSF) Specimens in Children Aged <5
Years old in China, South Korea, and Vietnam
Surveillance periods: China, January 1, 2000-December 31, 2002; South Korea, September 1, 1999-December 31, 2001; Vietnam, March 4, 2000-March 3, 2002. Of 2032 CSF specimens tested, 284 were confirmed by PCR and 44 specimens underwent sequencing to confirm serogroup.
*One specimen could not be linked with the clinical database.
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