Meningococcal disease in North America: Updates from the Global Meningococcal Initiative

Edwin J Asturias; Xilian Bai; Julie A Bettinger; Ray Borrow; Delia Nais Castillo; Dominique A Caugant; Grettel Chanto Chacon; Ener Cagri Dinleyici; Gabriela Echaniz-Aviles; Luis Garcia; Linda Glennie; Lee H Harrison; Rebecca L Howie; Mark Itsko; Jay Lucidarme; Jose Eduardo Oliva Marin; Henju Marjuki; Lucy A McNamara; Mustapha M Mustapha; Joan L Robinson; Belkis Romeu; Manish Sadarangani; Xavier Sáez-Llorens; Marco A P Sáfadi; David S Stephens; James M Stuart; Muhamed-Kheir Taha; Raymond S W Tsang; Julio Vazquez; Philippe De Wals

doi:10.1016/j.jinf.2022.10.022

Meningococcal disease in North America: Updates from the Global Meningococcal Initiative

J Infect. 2022 Dec;85(6):611-622. doi: 10.1016/j.jinf.2022.10.022. Epub 2022 Oct 20.

Authors

Edwin J Asturias¹, Xilian Bai², Julie A Bettinger³, Ray Borrow⁴, Delia Nais Castillo⁵, Dominique A Caugant⁶, Grettel Chanto Chacon⁷, Ener Cagri Dinleyici⁸, Gabriela Echaniz-Aviles⁹, Luis Garcia¹⁰, Linda Glennie¹¹, Lee H Harrison¹², Rebecca L Howie¹³, Mark Itsko¹⁴, Jay Lucidarme², Jose Eduardo Oliva Marin¹⁵, Henju Marjuki¹³, Lucy A McNamara¹³, Mustapha M Mustapha¹⁶, Joan L Robinson¹⁷, Belkis Romeu¹⁰, Manish Sadarangani³, Xavier Sáez-Llorens¹⁸, Marco A P Sáfadi¹⁹, David S Stephens²⁰, James M Stuart²¹, Muhamed-Kheir Taha²², Raymond S W Tsang²³, Julio Vazquez²⁴, Philippe De Wals²⁵

Affiliations

¹ University of Colorado School of Medicine and Colorado School of Public Health, Aurora, CO, USA.
² Meningococcal Reference Unit, UK Health Security Agency, Manchester, UK.
³ Vaccine Evaluation Center, British Colombia Children's Hospital Research Institute, and Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.
⁴ Meningococcal Reference Unit, UK Health Security Agency, Manchester, UK. Electronic address: ray.borrow@ukhsa.gov.uk.
⁵ Ministry of Public Health, Dominican Republic.
⁶ Norwegian Institute of Public Health, Oslo, Norway.
⁷ National Reference Center of Bacteriology, Costa Rica.
⁸ Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkiye.
⁹ Center for Research on Infectious Diseases, Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
¹⁰ Center for State Control of Drugs, Medical Devices and Equipment, Cuba.
¹¹ Meningitis Research Foundation, Bristol, UK.
¹² Center for Genomic Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
¹³ Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, USA.
¹⁴ WDS Inc., Contractor to Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, Centers for Disease Control and Prevention, USA.
¹⁵ National Institute of Public Health, El Salvador.
¹⁶ New York City Department of Health and Mental Hygiene, USA.
¹⁷ University of Alberta, Edmonton, Alberta, Canada.
¹⁸ Hospital del Niño - Dr José Renán Esquivel, Distinguished Investigator at Senacyt (SNI) and Cevaxin, Panama City, Panama.
¹⁹ Department of Pediatrics, Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil.
²⁰ Robert W. Woodruff Health Sciences Center, Emory University, Atlanta, GA, USA.
²¹ University of Bristol, Bristol, UK.
²² Institut Pasteur, National Reference Centre for Meningococci and Haemophilus influenzae, Paris, France.
²³ National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
²⁴ National Centre of Microbiology, Institute of Health Carlos III, Madrid, Spain.
²⁵ Laval University, Quebec City, Quebec, Canada.

Abstract

This review summarizes the recent Global Meningococcal Initiative (GMI) regional meeting, which explored meningococcal disease in North America. Invasive meningococcal disease (IMD) cases are documented through both passive and active surveillance networks. IMD appears to be decreasing in many areas, such as the Dominican Republic (2016: 18 cases; 2021: 2 cases) and Panama (2008: 1 case/100,000; 2021: <0.1 cases/100,000); however, there is notable regional and temporal variation. Outbreaks persist in at-risk subpopulations, such as people experiencing homelessness in the US and migrants in Mexico. The recent emergence of β-lactamase-positive and ciprofloxacin-resistant meningococci in the US is a major concern. While vaccination practices vary across North America, vaccine uptake remains relatively high. Monovalent and multivalent conjugate vaccines (which many countries in North America primarily use) can provide herd protection. However, there is no evidence that group B vaccines reduce meningococcal carriage. The coronavirus pandemic illustrates that following public health crises, enhanced surveillance of disease epidemiology and catch-up vaccine schedules is key. Whole genome sequencing is a key epidemiological tool for identifying IMD strain emergence and the evaluation of vaccine strain coverage. The Global Roadmap on Defeating Meningitis by 2030 remains a focus of the GMI.

Keywords: Antibiotic resistance; Meningitis; Meningococcal; Neisseria species; North America; Vaccination.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Humans
Incidence
Meningitis, Meningococcal* / epidemiology
Meningococcal Infections* / epidemiology
Meningococcal Infections* / prevention & control
Meningococcal Vaccines*
Neisseria meningitidis* / genetics
Vaccines, Conjugate

Substances

Meningococcal Vaccines
Vaccines, Conjugate

Grants and funding

CC999999/ImCDC/Intramural CDC HHS/United States