What are the different serotypes prevalent globally?
Epidemiology in India• IAPCOI does not recommend meningococcal vaccination to all children. It is recommended only for High risk individuals. What is the rationale of this?• What is the epidemiology of meningococcal infections in India? A. Endemic B. Sporadic C. Occurs only as outbreaks D. Sporadic with outbreaks
What are the various meningococcal vaccines available ?
Meningococcal Vaccines Purified capsular polysaccharide vaccines Bivalent vaccine against serogroups A and C Quadrivalent vaccine for serogroups A,C, Y and W135 Protein-polysaccharide conjugate vaccines. Three monovalent meningococcal C conjugate vaccines (Not available in India) Two quadrivalent conjugate vaccine (ACYW135) (Menactra & Menveo--Not available in India) Conjugate vaccines may be a better choice when available in India
Why is there no vaccine against serogroup B at present?
What are target groups for routine meningococcal vaccination in India ?
IAPCOI- High Risk• Age -children > 2 yrs (> 3 months if risk e.g. outbreaks/ contacts , children with terminal complement component deficiencies.• Children with functional/ anatomic asplenia/ hyposplenia (vaccination 2 weeks prior to splenectomy)• Laboratory personnel• Travelers to Saudi Arabia for Haj• Travelers to the African meningitis belt particularly between Dec to June• Adjunct to chemoprophylaxis in close contacts• Students going for study abroad
Scenario• Many cases of Meningococcal meningitis reported from Delhi. How many cases make it an outbreak ?• Should meningococcal vaccine be given to all the children? What is the role of meningococcal vaccine during outbreaks? Which vaccine can be used?• What is the role of ‘mass chemoprophylaxis’ during an outbreak situation?
Case 1• Nine-mo-old Ishan is hospitalized with meningitis and the doctors say it is meningococcal meningitis.• Should his 4 y sister be administered meningococcal vaccine ?
Case 2• Arnav is going for higher studies to Imperial University, London, UK. The university form asks if meningococcal vaccine has been administered.• What vaccine should be given to him and how many doses?• Can he take it just a day prior to his departure ?
Case 3• Suhas, 8 years, has recently shifted to US with his parents. He has already received a dose of quadrivalent conjugate meningococcal vaccine one year earlier.• Should he need to take another dose of the meningococcal vaccine?• What are the current recommendations of CDC/ACIP on booster dose of conjugate meningococcal vaccines?
Case 4• A concerned parent from Delhi visits your clinic and enquires about meningococcal disease, its seriousness and prevention in v/o death of his adolescent relative during Delhi epidemic in 2006-07• How will you counsel him?
Case 5• The parents of a 15 yrs old girl who came to you for HPV vaccination enquires about meningococcal vaccination since she is planning to go to a hostel in NE region, particularly in v/o a recently occurred mini- outbreak in Mizoram. She is also in constant contact with her 5 yrs old splenectomized brother.• How will you counsel them?