Situación epidemiológica de las meningoencefalitis bacterianas / Epidemiological situation of bacterial meningoencephalitis

Se describen los casos de meningoencefalitis bacterianas exponiendo el análisis histórico de algunas variables y a continuación la información desde la Semana epidemiológica (SE) 1 a la 25 del año 2017 que provienen de la notificación por canales oficiales: SNVS (módulos C2/SIVILA) y SIC (Sistema de Información epidemiológica de CABA). El análisis de las infecciones invasivas no meníngeas será realizado en próximas actualizaciones. Los casos fueron notificados a través de estos sistemas por los efectores públicos y privados de la Ciudad. El análisis de los mismos se realizó de manera individual a fin de evitar duplicaciones, excluyendo los casos descartados e integrando la información en una base unificada. Se incluyeron como residentes de CABA a todos aquellos que se domicilian en la Ciudad y aquellos casos atendidos en efectores de la CABA cuyo domicilio es desconocido al momento del análisis. La construcción de las tasas, se realizó en base a las proyecciones poblacionales aportadas por la Dirección de Estadística y Censos (DGEyC) de la Ciudad Autónoma de Buenos Aires. (AU)

Seroprevalence of bactericidal antibodies against serogroup B and C Meningococci in a University Hospital

Meningococcus serogroup B (MenB), clonal complex 32 (cc 32), was the Brazilian epidemic strain of meningococcal disease (MD) in the 1990’s. Currently, meningococcus serogroup C (MenC), cc 103, is responsible for most of the cases of the disease in Brazil. The aim of this study was to investigate the seroprevalence of bactericidal antibody (SBA) against representative epidemic strains of MenC, (N753/00 strain, C:23:P1.22,14-6, cc103) and MenB, (Cu385/83 strain, B:4,7:P1.15,19, cc32) in students and employees of a university hospital in the State of Rio Grande do Sul (RS, Brazil). A second MenC strain (N79/96, C:2b:P1.5-2,10, cc 8) was used as a prototype strain of Rio de Janeiro’s outbreak that occurred in the 1990’s. Our previous study showed a 9% rate of asymptomatic carriers in these same individuals. A second goal was to compare the SBA prevalence in meningococcal carriers and non-carriers. Fifty-nine percent of the studied population showed protective levels of SBA titers (log2≥2) against at least one of the three strains. About 40% of the individuals had protective levels of SBA against N753/00 and Cu385/83 strains. Nonetheless, only 22% of the individuals showed protective levels against N79/96 strain. Significantly higher antibody levels were seen in carriers compared to non-carriers (P≤0.009). This study showed that, similar to other States in Brazil, a MenC (23:P1.22,14-6, cc103) strain with epidemic potential is circulating in this hospital. Close control by the Epidemiological Surveillance Agency of RS of the number of cases of MD caused by MenC strains in the State is recommended to prevent a new disease outbreak.

Meningococcal immunization among emergency room health care workers in Almadinah Almunawwarah, Saudi Arabia

Meningococcal diseases are recognized worldwide, and regionally, Almadinah Almunawwarah experiences a substantial number of suspected cases of meningococcal diseases. This study reports the prevalence of meningococcal vaccination uptake in ER health care workers [HCWs] in Almadinah Almunawwarah, Kingdom of Saudi Arabia [KSA]. In this cross-sectional study conducted in December 2012, HCWs serving four hospitals under the ministry of health [MOH] were asked about their meningococcal vaccination status. Data were collected using a self-administered questionnaire that asked participants about their demographic characteristics and meningococcal vaccination status. Among the 321 respondents, 32.1% were physicians, and 45.8% were nurses. Fifty-seven percent of the respondents were Saudi, and the other respondents were of other nationalities. Among all participants, 84.7% had received the vaccine, 37.1% did not receive it regularly and 15.3% had never been vaccinated. Among all vaccinated participants, 60.7% received the vaccine to protect themselves from illness, 2%-4.1% received it to obtain a Hajj certificate and 13% received it as part of a preemployment procedure. The barriers to vaccination declared by the 15.3% of participants who did not receive the vaccine were unavailability of the vaccine, difficultly accessing the vaccine and poor scheduling, and these barriers were declared by 33.3%, 20.4% and 18.4% of the unvaccinated participants, respectively. Although KSA has witnessed a number of outbreaks of meningococcal diseases, the majority of the vaccinated respondents in this study had not received the vaccine according to the recommendations of the Saudi MOH

Short-term and long-term antibody response by mice after immunization against Neisseria meningitidis B or diphtheria toxoid

Serogroup B Neisseria meningitidis (MenB) is a major cause of invasive disease in early childhood worldwide. The only MenB vaccine available in Brazil was produced in Cuba and has shown unsatisfactory efficacy when used to immunize millions of children in Brazil. In the present study, we compared the specific functional antibody responses evoked by the Cuban MenB vaccine with a standard vaccine against diphtheria (DTP: diphtheria, tetanus, pertussis) after primary immunization and boosting of mice. The peak of bactericidal and opsonic antibody titers to MenB and of neutralizing antibodies to diphtheria toxoid (DT) was reached after triple immunization with the MenB vaccine or DTP vaccine, respectively. However, 4 months after immunization, protective DT antibody levels were present in all DTP-vaccinated mice but in only 20% of the mice immunized against MenB. After 6 months of primary immunization, about 70% of animals still had protective neutralizing DT antibodies, but none had significant bactericidal antibodies to MenB. The booster doses of DTP or MenB vaccines produced a significant antibody recall response, suggesting that both vaccines were able to generate and maintain memory B cells during the period studied (6 months post-triple immunization). Therefore, due to the short duration of serological memory induced by the MenB vaccine (VA-MENGOC-BC® vaccine), its use should be restricted to outbreaks of meningococcal disease.

Immune associated complication in meningococcal disease; a report of two cases

Meningococcal disease is one of the most feared infections in children. In recent years, little attention has been focused on the complications of meningococcal disease in the sub-acute phase, the so-called immune associated complications. Its main features are arthritis, vasculitis, episcleritis, pericarditis and very rarely nephritis. We report two siblings with meningococcal disease. The first developed arthritis and vasculitis while the younger sister developed only arthritis of the right ankle. To the best of our knowledge this is the first case report to be published in Kuwait

Peptide Mimotopes of Neisseria meningitidis Group B Capsular Polysaccharide

The antigenic similarity between Neisseria meningitidis group B (NMGB) capsular polysaccharide (PS) and human polysialic acid (PSA) has hampered the development of a NMGB PS-based vaccine. But the possibility of a safe vaccine based on NMGB PS has been demonstrated by the existence of the NMGB PS-associated nonautoreactive epitope, which is distinct from those present on human PSA. To obtain peptide mimotopes of NMGB PS, we used HmenB3, a protective and nonautoreactive monoclonal antibody, to screen a phage library with 12 amino acids. We obtained 23 phage clones that bound to HmenB3 but not in the presence of E. coli K1 PS [which is alpha (2-8) -linked PSA like NMGB PS]. The clones contained 3 mimotopes and differed from previously described NMGB PS mimotopes. Immunization with a synthetic peptide of one mimotope elicited anti-NMGB antibodies in BALB/c mice. These mimotopes may be useful in the development of group B meningococcal vaccines.

Monoclonal antibody to serotype 17 of Neisseria Meningitidis and-their prevalence in brazilian states

Neisseria meningitidis sao diplococos Gram negativos responsaveis por casos de doencas meningococica em todo o mundo. O potencial epidemico de N. meningitidis sorogrupos B e C e claramente mais uma funcao de seus antigenos de sorotipo que de seu polissacaride capsular. Ate recentemente soros hiperimune foram usados para detectar antigenos de sorotipo em bacterias. O advento de anticorpos monoclonais ofereceu a oportunidade de eliminar muitas das reacoes cruzadas e tem melhorado a acuracidade e reprodutibilidade da sorotipagem de meningococo. Nos produzimos um anticorpo monoclonal contra proteina de membrana externa do sorotipo 17 que ate entao tem sido detectado atraves do uso de soro policlonal. A prevalencia deste epitopo de sorotipo e baixa nas cepas brasileiras. Usando-se este anticorpo monoclonal em cepas brasileiras, nao pudemos diminuir a porcetagem de cepas sorogrupo C nao tipaveis, entretanto, houve uma diminuicao de 13 por cento em cepas sorogrupo B nao tipaveis e 25 por cento em cepas de outros sorogrupos.

effect of current meningococcal vaccination on meningococcal carriage among new army recruits

The impact of vaccination with the bivalent meningococcal vaccine on meningococcal carriage was studied by examining nasopharyngeal smears from vaccinated and non-vaccinated new military recruits. Initial nasopharyngeal swabs were taken from 120 new military recruits and cultured for N.meningitidis 2 days after their entry to the army. Sixty recruits then received the N.meningitidis group A and C polysaccharide vaccine and the other 60 recruits did not. Follow-up swabs from both groups were cultured for N. meningitides after 2, 6 and 10 weeks. The overall carriage rate for N. meningitides in the 120 recruits was 30 percent: 52.7 percent for serogroup A, 19.4 percent for serogroup B, 22.2 percent for serogroup C and 5.5 percent for the autoagglutinable group. In the vaccinated group the overall carriage rate did not change significantly over the follow-up period. However, there was a progressive increase of serogroup B prevalence over the follow-up period [from 23.8 percent initially to 65.2 percent 10 weeks after vaccination] P= 0.01. In the non-vaccinated group, the overall carriage rate increased significantly over the follow-up period [from 25 percent initially to 46.7 percent at 10 weeks]. P= 0.04; the sero group prevalence did not change significantly. The results of this study suggest that meningococcal A and C polysaccharide vaccine may inhibit the nasopharyngeal carriage of group specific meningococcal in new army recruits. This inhibition is, however, offset by an increased prevalence of sero group B meningococcal