The MRF Genome Library: Epidemiology of meningococcal disease-causing lineages in England and Wales from 2010/11 to 2011/12
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Dorothea Hill's presentation on her poster at Meningitis Research Foundtion's 2013 conference, Meningitis & Septicaemia in Children & Adults
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Prof Rob Heyderman
The document discusses the Global Meningitis Genome Partnership (GMGP), which aims to address inequities in genomic surveillance capacity for meningitis pathogens between high-income and low-income countries. It outlines what has been achieved so far, including establishing standardized metadata for sequencing and epidemiological data. The GMGP is working to incorporate genome surveillance into regional surveillance strategies, initially focusing on Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus agalactiae in Africa. Open data sharing is encouraged according to clear governance policies. Standardizing metadata and curating sequencing data in a central library are discussed to facilitate consistent analysis and data visualization for public health benefit
Marco safadi
- There was a significant reduction in cases of invasive bacterial infections like pneumococcal disease, H. influenzae, and meningococcal disease in 2020 coinciding with COVID-19 containment measures across many countries. Vaccination coverage rates have decreased dramatically in Brazil representing a potential risk of rebound in infectious disease rates. Maintaining disease surveillance is important to inform authorities on current disease burden and carriage rates even though some diseases were reduced during the pandemic.
Brenda kwambana adams
This document discusses optimal schedules for controlling pneumococcal infection in countries with high and low carriage. It notes that the African Meningitis Belt has seen sub-optimal pneumococcal conjugate vaccine (PCV) coverage due to geopolitical factors and vulnerable populations. Outbreaks in Ghana pre- and post-PCV introduction show that herd protection may be inadequate. Research is needed to better understand pneumococcal biology and prevention. Improving PCV access and coverage, including schedules with boosters and catch-up campaigns targeting 5-29 year olds, may help prevent outbreaks. Strengthening surveillance systems allows rapid response.
Professor Muhamed-Kheir Taha
Professor Muhamed-Kheir TAHA MD, PhD, HDR presented on lessons and impacts for meningitis in the COVID-19 era. Data showed cumulative cases of invasive meningococcal disease (IMD) from 2014-2020 in France as well as distribution of IMD cases from 2011-2020. Vaccine use in France declined during the COVID-19 pandemic in 2020, with reduced doses of the 5-month and 12-month vaccines. Distribution of IMD cases by age group from 2011-2021 showed an immunity gap in childhood due to the pandemic. Conclusions were that reduced pathogen circulation may decrease herd immunity, social distancing was associated with lower vaccine uptake, and countries need plans to promote
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Progress is being made on developing a combined MenABCWY vaccine. Studies are underway evaluating the immunogenicity and safety of combining different meningococcal vaccines that target serogroups A, C, W, Y. Combining the vaccines could simplify immunization schedules, reduce costs by needing fewer doses, and increase vaccination uptake by reducing the number of required injections. However, a combined vaccine may also increase reactogenicity and interfere with the immune response to other concomitant vaccines. Ongoing studies are evaluating different potential MenABCWY vaccine combinations to determine the optimal formulation.
Dr william hanage
This document discusses pneumococcal genomics, vaccines, and antibiotic resistance. It examines how pneumococcal carriage and disease changes following vaccination as non-vaccine serotypes increase. The author analyzed carriage samples from Native American communities before and after vaccination, finding 35 sequence clusters but vaccination did not change overall carriage prevalence. The document explores how the accessory genome varies between locations and how negative frequency dependent selection structures pneumococcal populations. Models are developed to predict which sequence clusters may increase or decrease following vaccination based on accessory genome content and frequency dependent fitness. Comparisons are made between predicted and actual changes in sequence cluster prevalence post-vaccination.
Dr Maria Deloria Knoll
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Professor Nelesh govender
Cryptococcal meningitis is responsible for 15% of AIDS-related deaths globally. A strategic framework is needed to end cryptococcal meningitis deaths by 2030 by addressing gaps in screening, diagnosis, and access to critical antifungal medicines. Key targets include expanding access to CD4 and cryptococcal antigen tests, improving availability of lumbar puncture and antifungal drugs, and increasing research to develop better diagnostics and treatments.
Professor Sir Andrew Pollard
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Dr Manuel krone
This document summarizes changes in invasive meningococcal disease (IMD) cases in Germany during the COVID-19 pandemic. It finds that overall IMD cases decreased during the first pandemic period (PP) in 2020 compared to pre-pandemic levels, with the largest declines in children ages 1-4 and 5-9. However, IMD cases increased again after restrictions eased. The decrease in IMD cases during increased restrictions correlates with decreased mobility based on Google mobility indices.
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1) The PSERENADE project analyzed surveillance data from over 50 sites in 34 countries to assess the impact of PCV10 and PCV13 introduction on pneumococcal meningitis incidence globally in children under 5 years old and adults 18 years and older.
2) For both age groups, PCV10 and PCV13 significantly reduced meningitis caused by serotypes covered by the vaccines, with almost elimination in children under 5 years old within 5 years. Herd protection was observed in adults as well.
3) PCV13 significantly reduced meningitis from additional serotypes it covers compared to PCV10, though serotype 19A increased with PCV10 and serotype 3 trends were unclear
Dr Rodolfo villena
This study examined sequelae in 49 pediatric patients with invasive meningococcal disease (IMD) in Chile between 2009-2019. The researchers found that 59% of patients experienced sequelae at hospital discharge, with neurological disorders being the most common at 59.2%. Risk factors for sequelae included age under 1 year old, shock, and meningeal signs at admission. Sequelae were also associated with a clinical diagnosis of meningitis with meningococcemia. The study concludes that multidisciplinary follow-up is needed to reduce the long-term impacts of IMD in children.
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Professor Cal MacLennan
Gonorrhea is a sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae that can lead to serious health complications if left untreated. There is an urgent need for a gonorrhea vaccine due to increasing antibiotic resistance and the potential for the disease to become untreatable. However, vaccine development faces several difficulties as N. gonorrhoeae is highly variable, able to avoid the immune system, and past vaccine trials have shown no efficacy. Continued research is focused on identifying conserved antigens that could induce a protective immune response through vaccination.
Dr Sami gottlieb
Dr. Sami Gottlieb of the World Health Organization discussed the potential for meningococcal B (MenB) vaccines to help prevent gonococcal infection on a global scale. MenB vaccines have shown preliminary efficacy against gonorrhea in clinical trials and epidemiological data. WHO is working to define priority populations for gonorrhea vaccines and assess how existing MenB programs could be leveraged. Effectiveness may depend on disease epidemiology, vaccine characteristics, target populations, and integration with current immunization systems. Ongoing trials of MenB vaccines against gonorrhea will provide critical data to inform introduction decisions.
Dr Lee hampton
Gavi has supported the rollout of the Meningococcal A Conjugate Vaccine (MenAfrivac) in 26 African countries since 2010 through routine immunization and preventive campaigns for those aged 1-29. No cases of meningococcal A have been identified in the African meningitis belt since 2018. In 2018, non-A outbreaks prompted Gavi to authorize support for multivalent meningococcal conjugate vaccines contingent on regulatory approval, review processes, and cost targets being met. The estimated cost per death averted for the risk-based multivalent meningococcal conjugate vaccine program would be $6,300 to $13,400.
Professor Stefan flasche
While pneumococcal disease primarily burdens infants in their first year of life, relying on herd effects from PCV schedules could help protect others indirectly and reduce costs. However, caution is needed, as indirect protection depends on direct protection of main transmitters, and key questions remain around who transmits, the duration of protection from boosters, and lessons from cRCTs comparing 2-dose and 3-dose schedules in Malawi and Gambia. Programmatic concerns like booster dose coverage, incomplete dosing, travel/border effects, and lack of surveillance also warrant consideration.
Professor Shrijana shrestha
The document discusses Nepal's introduction of the PCV 10 vaccine using a 2+1 schedule of administration at 6 weeks, 10 weeks, and 9 months. A trial found this schedule to be equally effective as a 3+0 schedule. Surveillance data showed declines in invasive pneumococcal disease cases and pneumonia with consolidation following vaccine introduction. Pneumococcal carriage among children with clinical pneumonia under 2 years old declined significantly, but no decrease was seen in older children. Short term impact was observed using the 2+1 schedule, but continued surveillance is needed to assess long term vaccine impact.
Professor David goldblatt
The document discusses optimal vaccination schedules for pneumococcal disease in countries with high and low disease carriage. It summarizes studies comparing 1+1 and 2+1 vaccination schedules for PCV10 and PCV13 vaccines. The studies found immunogenicity was equivalent or higher for many serotypes with 1+1 schedules. The UK switched to a 1+1 schedule in 2020 and ongoing surveillance will monitor its impact on invasive pneumococcal disease cases. Future studies will evaluate the impact of the schedule change and potential for disease rebound over time.
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1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
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2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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- 1. The MRF Meningococcus Genome Library www.meningitis.org/research/genome Dorothea Hill University of Oxford MRF conference 2013 Wednesday 6th November
- 2. ‘Publicly accessible data requires a stable home and someone to pay the mortgage.’ Dr. Francine Berman, Research Data Alliance Funding MRU: Isolates Illumina genome sequencing BIGS database http://pubmlst.org
- 3. Whole-genome population structure with ‘Genome Comparator’: two CC269 (lineage 2) sub-lineages. lineage 2.2 261 loci Incl. ST-275, ST-1161 lineage 2.1 Incl. ST-269, ST-467, ST-283 451 loci lineage 5 (CC32) 100 loci
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