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Changes in Neisseria meningitidis Disease Epidemiology in the United States, 1998–2007: Implications for Prevention of Meningococcal Disease

Cohn, Amanda C., MacNeil, Jessica R., Harrison, Lee H., Hatcher, Cynthia, Theodore, Jordan, Schmidt, Mark, Pondo, Tracy, Arnold, Kathryn E. +15 more·2010·Clinical Infectious Diseases
DOI 10.1086/649209
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Abstract

BACKGROUND: In January 2005, a quadrivalent (serogroups A, C , Y, and W-135) meningococcal conjugate vaccine was licensed for use in adolescents. This report describes the epidemiologic features of meningococcal disease in the United States from January 1998 through December 2007, before and during implementation of adolescent quadrivalent meningococcal conjugate vaccination. METHODS: Data were collected from active surveillance for invasive Neisseria meningitidis conducted through the Active Bacterial Core surveillance (ABCs) sites during 1998-2007. Isolates from cases were serogrouped at the ABCs site and confirmed at the Centers for Disease Control and Prevention. Estimates of the incidence and number of cases in the 50 states were calculated, standardizing for race and age group. RESULTS: In the period 1998-2007, a total of 2262 cases of meningococcal disease were reported from ABCs sites; 11.3% of these cases were fatal. The estimated United States average annual incidence of meningococcal disease was 0.53 cases per 100,000 population (95% confidence interval, 0.51-0.55), and an estimated 1525 (95% confidence interval, 1470-1598) cases occurred annually. The annual incidence decreased 64.1%, from 0.92 cases per 100,000 population in 1998 to 0.33 cases per 100,000 population in 2007. Infants aged <1 year have the highest incidence of meningococcal disease (5.38 cases per 100,000 population). After introduction of the quadrivalent meningococcal conjugate vaccine, no significant decrease in serogroup C or Y meningococcal disease was seen among those aged 11-19 years in 2006-2007, compared with 2004-2005. CONCLUSIONS: Before the introduction of the quadrivalent meningococcal conjugate vaccine, the incidence of meningococcal disease in the United States decreased to a historic low. However, meningococcal disease still causes a substantial burden of disease among all age groups. Future vaccination strategies may include targeting infants and preventing serogroup B meningococcal disease.

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  • Vaccines targeted against N. meningitidis serogroups A or C, or a tetravalent A, C, Y, and W135 vaccine have been incorporated into vaccine programs in many countries and have led to a documented decrease in cases due to these serogroups.

    “Vaccines targeted against N. meningitidis serogroups A or C, or a tetravalent A, C, Y, and W135 vaccine have been incorporated into vaccine programs in many countries over recent years, and have led to a documented decrease in cases due to these serogroups. [11, 12]”

    From Global etiology of bacterial meningitis: A systematic review and meta-analysis. (2018) · cites this paper as [12]

    The introduction reports routine use of a quadrivalent A, C, Y, and W-135 vaccine in the United States and use of serogroup C infant vaccines in several countries in Europe, Canada, and Australia. It does not document vaccine-caused declines across those countries. The Abstract and Discussion instead report no significant decline in C or Y disease among US adolescents shortly after quadrivalent vaccine introduction; the broader US decline began before its implementation. Page numbers are unavailable in our copy. (LLM, conf=0.88)

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Research works printed but not linked: 13

  1. Rosenstein NE, Perkins BA, Stephens DS, Popovic T, Hughes JM. Me- ningococcal disease. N Engl J Med 2001; 344:1378-88.
  2. Centers for Disease Control and Prevention. Revised recommendations of the Advisory Committee on Immunization Practices to vaccinate all persons aged 11-18 years with meningococcal conjugate vaccine. MMWR Morb Mortal Wkly Rep 2007; 56:794-5.
  3. Centers for Disease Control and Prevention. Notice to readers: rec- ommendation from the Advisory Committee on Immunization Prac- tices (ACIP) for use of quadrivalent meningococcal conjugate vac- cine (MCV4) in children aged 2-10 years at increased risk for in- vasive meningococcal disease. MMWR Morb Mortal Wkly Rep 2007; 56:1265-6.
  4. Centers for Disease Control and Prevention. National vaccination cov- erage among adolescents aged 13-17 years: United States, 2007. MMWR Morb Mortal Wkly Rep 2008; 57:1100-3.
  5. Snape M, Dawson T, Morant A, et al. Immunogenicity and reacto- genicity of a novel serogroup B Neisseria meningitidis vaccine admin- istered from 6 months of age. In: Program and abstracts of the Inter- national Pathogenic Neisseria Conference. Rotterdam: International Pathogenic Neisseria Conference, 2008. Abstract 069.
  6. Jiang H, Harris S, Tan C, et al. Prediction of broad vaccine coverage for a bivalent rLP2086 based vaccine which elicits serum bactericidal activity against a diverse collection of serogroup B meningococci. In: Program and abstracts of the International Pathogenic Neisseria Con- ference. Rotterdam: International Pathogenic Neisseria Conference, 2008. Abstract 041.
  7. Harrison LH, Shutt K, Marsh J, et al. Evidence of capsular switching in invasive Neisseria meningitidis isolates in the pre-meningococcal conjugate vaccine era, United States, 2000-2005. In: Program and ab- stracts of the International Pathogenic Neisseria Conference. Rotter- dam: International Pathogenic Neisseria Conference, 2008. Abstract 051.
  8. Centers for Disease Control and Prevention. Serogroup B meningo- coccal disease: Oregon, 1994. MMWR Morb Mortal Wkly Rep 1995; 44:121-4.
  9. Fay M, Feuer E. Confidence intervals for directly standardized rates: a method based on the gamma distribution. Stat Med 1997; 16:791-801.
  10. Granoff DM, Harrison LH, Borrow R. Meningococcal vaccines. In: Plot- kin SA, Orenstein WA, eds. Vaccines. 5th ed. Philadelphia, PA: Saunders Elsevier, 2008:399-434.
  11. Centers for Disease Control and Prevention. Cigarette use among high school students: United States, 1991-2007. MMWR Morb Mortal Wkly Rep 2008; 57:689-91.
  12. Harrison LH, Jolley KA, Shutt KA, et al. Antigenic shift and the in- cidence of meningococcal disease. J Infect Dis 2006; 193:1266-74.
  13. Shepard CW, Rosenstein NE, Fischer M; Active Bacterial Core Sur- veillance Team. Neonatal meningococcal disease in the United States, 1990 to 1999. Pediatr Infect Dis J 2003; 22:418-22.

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Authors
Cohn, A. C., MacNeil, J. R., Harrison, L. H., Hatcher, C., Theodore, J., Schmidt, M., Pondo, T., Arnold, K. E., Baumbach, J., Bennett, N., Craig, A. S., Farley, M., Gershman, K., Petit, S., Lynfield, R., Reingold, A., Schaffner, W., Shutt, K. A., Zell, E. R., Mayer, L. W., Clark, T., Stephens, D., & Messonnier, N. E.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Johns Hopkins University (US)
  • Oregon Department of Human Services (US)
  • Georgia Department of Public Health (US)
  • New Mexico Department of Health (US)
  • New York State Department of Health (US)
  • Tennessee Department of Health (US)
  • Emory University (US)
  • Colorado Department of Public Health and Environment (US)
  • Connecticut Department of Public Health (US)
  • Minnesota Department of Health (US)
  • University of California, Berkeley (US)
  • Vanderbilt University (US)
  • University of Pittsburgh (US)
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2010-01-15
Volume
50
Issue
2
Pages
184-191
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/649209
OpenAlex
W2120356293
Cited by
345
References
18
Citations by year
2026: 9 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 5 · 2021: 6 · 2020: 14 · 2019: 9 · 2018: 20 · 2017: 25 · 2016: 30 · 2015: 42 · 2014: 33 · 2013: 44 · 2012: 37
FWCI
32.27
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • GlaxoSmithKline
  • Sanofi
  • University of Pittsburgh
  • Centers for Disease Control and Prevention
Topics
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
  • Life Sciences › Immunology and Microbiology › Microbiology › Microbial infections and disease research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
Keywords
Neisseria meningitidis, meningococcal disease, invasive meningococcal disease, quadrivalent meningococcal conjugate vaccine, serogroup distribution, serogroup C, serogroup Y, serogroup A, incidence trends, adolescent vaccination, vaccine impact, mortality, infants, United States, Active Bacterial Core surveillance
MeSH terms
Adolescent, Adult, Aged, Child, Child, Preschool, Female, Humans, Infant, Male, Meningitis, Meningococcal, Middle Aged, Time Factors, United States, Young Adult

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