Epidemiology of bacterial meningitis, the major serogroups (A, B, C, W, Y), available vaccines for each, and recommendation rationale for adolescents and college students.
Meningococcal disease refers to infections caused by the bacterium Neisseria meningitidis, also known as the meningococcus. The most common presentations are meningococcal meningitis (inflammation of the membranes surrounding the brain and spinal cord) and meningococcemia (blood poisoning).
Meningococcal disease progresses rapidly and can lead to death within 24-48 hours even with appropriate antibiotic treatment. Among survivors, 10-20% suffer long-term sequelae including hearing loss, neurological damage, limb amputations, and skin scarring.
N. meningitidis is classified into 12 serogroups based on its polysaccharide capsule. Five serogroups (A, B, C, W, Y) cause the vast majority of disease worldwide.
Historically caused large epidemics in sub-Saharan Africa ("meningitis belt"). Now rare in U.S. with routine vaccination.
conjugate vaccine availableCurrently the most common cause of meningococcal disease in U.S. and Europe. Requires special vaccine (not polysaccharide-based).
protein-based vaccineSecond most common in U.S. Often causes localized outbreaks in communities and college campuses.
conjugate vaccine availableEmerging strain causing increased disease in some regions, including the UK and parts of Africa.
conjugate vaccine availableAccounted for increasing proportion of U.S. cases in recent years, along with W.
conjugate vaccine availableSanofi Pasteur. Quadrivalent (A, C, W, Y). FDA approved 2005.
GSK. Quadrivalent (A, C, W, Y). FDA approved 2010.
Sanofi Pasteur. Quadrivalent (A, C, W, Y). FDA approved 2020.
Pfizer. Two-dose or three-dose series. FDA approved 2014.
GSK. Two-dose or three-dose series. FDA approved 2015.