Giuseppe
Emeritus
[Source: The Lancet, full text: (LINK). Abstract, edited.]
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The Lancet, Volume 380, Issue 9854, Pages 1703 - 1711, 10 November 2012
doi:10.1016/S0140-6736(12)61187-8
This article can be found in the following collections: Infectious Diseases (Immunisation & vaccination, Neurological infections, Paediatric infections); Neurology (Neurological infections); Paediatrics (Paediatric infections)
Effect of vaccines on bacterial meningitis worldwide
Original Text
Prof Peter B McIntyre MD a, Prof Katherine L O'Brien MD b, Prof Brian Greenwood MD c, Prof Diederik van de Beek MD d
Summary
Three bacteria?Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis?account for most acute bacterial meningitis. Measurement of the effect of protein-polysaccharide conjugate vaccines is most reliable for H influenzae meningitis because one serotype and one age group account for more than 90% of cases and the incidence has been best measured in high-income countries where these vaccines have been used longest. Pneumococcal and meningococcal meningitis are caused by diverse serotypes and have a wide age distribution; measurement of their incidence is complicated by epidemics and scarcity of surveillance, especially in low-income countries. Near elimination of H influenzae meningitis has been documented after vaccine introduction. Despite greater than 90% reductions in disease attributable to vaccine serotypes, all-age pneumococcal meningitis has decreased by around 25%, with little data from low-income settings. Near elimination of serogroup C meningococcal meningitis has been documented in several high-income countries, boding well for the effect of a new serogroup A meningococcal conjugate vaccine in the African meningitis belt.
a National Centre for Immunisation Research and Surveillance of Vaccine-Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney, Sydney, NSW, Australia; b International Vaccine Access Center (IVAC) and Center for American Indian Health (CAIH), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; c Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; d Department of Neurology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
Correspondence to: Prof Peter McIntyre, National Centre for Immunisation Research and Surveillance of Vaccine-Preventable Diseases, Locked Bag 4001, Westmead, Sydney, NSW 2145, Australia
-doi:10.1016/S0140-6736(12)61187-8
This article can be found in the following collections: Infectious Diseases (Immunisation & vaccination, Neurological infections, Paediatric infections); Neurology (Neurological infections); Paediatrics (Paediatric infections)
Effect of vaccines on bacterial meningitis worldwide
Original Text
Prof Peter B McIntyre MD a, Prof Katherine L O'Brien MD b, Prof Brian Greenwood MD c, Prof Diederik van de Beek MD d
Summary
Three bacteria?Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis?account for most acute bacterial meningitis. Measurement of the effect of protein-polysaccharide conjugate vaccines is most reliable for H influenzae meningitis because one serotype and one age group account for more than 90% of cases and the incidence has been best measured in high-income countries where these vaccines have been used longest. Pneumococcal and meningococcal meningitis are caused by diverse serotypes and have a wide age distribution; measurement of their incidence is complicated by epidemics and scarcity of surveillance, especially in low-income countries. Near elimination of H influenzae meningitis has been documented after vaccine introduction. Despite greater than 90% reductions in disease attributable to vaccine serotypes, all-age pneumococcal meningitis has decreased by around 25%, with little data from low-income settings. Near elimination of serogroup C meningococcal meningitis has been documented in several high-income countries, boding well for the effect of a new serogroup A meningococcal conjugate vaccine in the African meningitis belt.
a National Centre for Immunisation Research and Surveillance of Vaccine-Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney, Sydney, NSW, Australia; b International Vaccine Access Center (IVAC) and Center for American Indian Health (CAIH), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; c Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; d Department of Neurology, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
Correspondence to: Prof Peter McIntyre, National Centre for Immunisation Research and Surveillance of Vaccine-Preventable Diseases, Locked Bag 4001, Westmead, Sydney, NSW 2145, Australia
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