Meningococcal Capsular Group A, C, W, and Y Conjugate Vaccines

Meningococcal disease, caused by the bacterium Neisseria meningitidis, is a deadly illness that can progress rapidly. The case fatality rate is 10%-15%, and many survivors have long term sequelae such as hearing loss, cognitive deficits, or amputations due to necrosis of the extremities. Meningococcal disease is found globally but the incidence and most common capsular groups (types) vary widely among world regions. In the past 15 years, huge advances have been made in new meningococcal vaccines, which are having a striking impact on the global epidemiology of meningococcal disease. This chapter provides a comprehensive review of serogroup A, C, W, and Y meningococcal disease and vaccines. The chapter includes discussion of the clinical presentation and complications of meningococcal disease; meningococcal bacteriology and molecular epidemiology; disease pathogenesis, transmission, diagnosis, treatment, and prophylaxis; and global epidemiology, including risk factors for both disease and asymptomatic carriage. The discussion of meningococcal conjugate vaccines includes a detailed review of meningococcal conjugate vaccine development, immunogenicity, effectiveness, impact on asymptomatic carriage, safety, recommendations for use, and public health impact.