Serogroup B Meningococcal Disease

Clinical Features

Fever, headache, stiff neck in meningitis cases, sepsis in others.

Etiologic Agent

Neisseria meningitidis, serogroup B

Incidence

3-50/100,000 in epidemics.
0.5-4/100,000 for endemic disease.
Worldwide distribution of occurrence.

Sequelae

10%-15% of cases fatal.
10% of surviving cases have permanent hearing loss.

Transmission

Respiratory droplets from nasopharyngeal carrier or case.

Risk Groups

General population in epidemic areas.
Infants and young children.
Household contacts.
Military.
Refugees.

Surveillance

International Disease Notification.

Trends

Has become most common cause of epidemic meningococcal disease in developed countries, including the US Pacific Northwest, as a result of a single virulent clone (known as ET-5).
No licensed vaccine is available in the US although three recently developed vaccines have been shown to be efficacious in older children and adults.
CDC has filed an Investigational New Drug (IND) application with the FDA for use of a Norwegian-produced serogroup B meningococcal vaccine in the US among laboratory workers at high risk for serogroup B meningococcal disease.

Challenges

License an effective vaccine for control of epidemic disease.
Develop a vaccine that is effective in young children.
Better understand protective humoral immunity.
Develop a vaccine which could be incorporated into routine childhood immunization for prevention of endemic disease.

Opportunities

Epidemic disease caused by a specific clone in many developed countries has generated widespread international interest in vaccine and prevention strategy development.

Research Priorities

Development of serogroup B meningococcal vaccines.
Standardization of serology for comparisons of different vaccines in different populations.
Development of sites and protocols for immunogenicity testing.
Development of approaches to long-term immunogenicity and efficacy evaluation.

April 1996
Courtesy of the Centers for Disease Control and Prevention