IMD: Only with Neisseria meningitis, carriers could transmit the disease to both infants and elderly

Worldwide carriage rates are low during infancy & peak at 19 Years of age1

1. Carried asymptomatically in the URT of 8-25% of healthy individuals (<1% of carriers become symptomatic) 1


2. Carriage may be much higher in closed communities 1, University halls, Military camps, and Boarding schools


3. Pharyngeal carriage is a precondition for IMD


4. Young adults are the most common source of transmission to the community2


5. Up to 10% of adolescents and adults are asymptomatic transient carriers 3

Meta-analysis of 89 Studies in 28 Countries1

    1. Christensen. Lancet Infect Dis. 2010;10(12);
    2. Pelton. Pediatr Infect Dis J. 2009;28(4);
    3. CDC. In: Epidemiology and Prevention of Vaccine-Preventable Diseases. (The Pink Book) 13th ed. 2015

UK 2017: Risk of IMD in University Students in England

 

University students, particularly first years entering direct from school, are at higher risk for IMD than non-students

    1. Sema Mandal, Risk of invasive meningococcal disease in university students in England and optimal strategies for protection using MenACWY vaccine, Vaccine 35 (2017) 5814–5818

2019: Observational study of nasopharyngeal carriage of Neisseria meningitidis in applicants to a military academy in the Russian Federation

Design

  • A prospective, observational study of adults aged >18 years from a military academy; applicants who had samples taken on arrival (Day 1- 671 applicants), (Day 30- 261 applicants) and 60 days- 261 applicants ).
  • N. meningitidis serogrouping was determined

    • Results: N. meningitidis was detected in:

    ❑ 6.2% of samples from Day 1,

    ❑ 7.7% of samples from Day 30

    ❑ 15.9% of samples from Day 60.

    N.b. Of the 20 carriers identified at Day 30, 11 were included negative results at Day 1

    Serogroup composition: Day 1, 40% serogroup B and 9% serogroup W dominant and Day 60, 58% serogroup W.

    Conclusions:There was an increase in carriers of serogroup W in this population. Given recent increases in outbreaks attributed to serogroup W.

    2019 Global incidence of IMD in adolescents by country

    Incidence per 100,000 persons

      1. HUMAN VACCINES & IMMUNOTHERAPEUTICS, 2019, VOL. 15, NO. 2, 459–469 https://doi.org/10.1080/21645515.2018.1528831

    2020: Meningococcal Carriage In Norwegian Teenagers

    Method:

  • Oropharyngeal swabs were collected from secondary-school students in southeastern Norway in 2018–2019.
  • Samples were obtained from 2296 12–24-year-olds (majority 13–19-year-olds).

    • Results:

  • N. meningitidis was identified in 167 (7.3%) individuals.
  • The highest carriage rate was found among 18-year-olds (16.4%).

    • Prevalence of carriers of N. meningitidis by age (n = 2296; carriers of N. meningitidis n = 167).

      1. S. V. Watle et al, Epidemiol Infect. 2020; 148: e80. Published online 2020 Mar 31. doi: 10.1017/S0950268820000734

    2021: The Burden of IMD in adolescents and adults in (MENA) Region Summary of studies for Neisseria meningitidis

    Kuwait Husain et al.
    [38]     		1987-2013 National population-based surveillance data 293 cases reported

    Mean annual incidence: 0.5 per 100,000. Adults aged ≥ 20 years accounted for 26% of all cases; 30% of cases in individuals ages > 14 years.

    Saudi Arabia Mmeish et al.
    [39]     		1995-2011 All IMD cases in the national surveillance data

    Mean annual incidence in the general population (per 100,00): 0.20 (1995-1999; before outbreak), 1.32-1.42 (2000-2001; outbreak), ≤ 0.06 (2002-2011; following MenACWY vaccination policy).
    Mean age of cases (1995-2011): 25.8 years.
    Most common serogroups (aged ≥ 15 years): W, 45%; A, 42%.
    CFR: aged > 45 years, 32.57%; aged 15-45 years, 19,41%.

    CFR case fatality rate, IMD invasive meningococcal disease, MenA meningococcal serogroup A, MenACWY quadrivalent meningococcal vaccine, MenB meningococcal serogroup B, MenW meningococcal serogroup W, OR odds ratio

      1. Infec  Dis Ther (221) 10:663–685, https://doi.org/10.1007/s40121-021-00420-y

    Epidemiology of meningitis in Al-Ain, United Arab Emirates, 2000—2005

    Number of cases in adolescents' group

    Causative agents of bacterial meningitis

      1. International Journal of Infectious Diseases (2007) 11, 309—312

    MAT-BH-2200533 -V2-June-2022