Frequent capsule switching in ‘ultra-virulent’ meningococci – Are we ready for a serogroup B ST-11 complex outbreak? - 06/10/17
Summary |
The meningococcal ST-11 complex (cc11) causes large invasive disease outbreaks with high case fatality rates, such as serogroup C (MenC) epidemics in industrialised nations in the 1990s and the serogroup W epidemic currently expanding globally. Glycoconjugate vaccines are available for serogroups A, C, W and Y. Broad coverage protein-based vaccines have recently been licensed against serogroup B meningococci (MenB), however, these do not afford universal MenB protection. Capsular switching from MenC to MenB among cc11 organisms is concerning because a large MenB cc11 (B:cc11) outbreak has the potential to cause significant morbidity and mortality. This study aimed to assess the potential for licensed and developmental non-capsular meningococcal vaccines to protect against B:cc11. The population structure and vaccine antigen distribution was determined for a panel of >800 geo-temporally diverse, predominantly MenC cc11 and B:cc11 genomes. The two licensed vaccines potentially protect against many but not all B:cc11 meningococci. Furthermore, strain coverage by these vaccines is often due to a single vaccine antigen and both vaccines are highly susceptible to vaccine escape owing to the apparent dispensability of key proteins used as vaccine antigens. cc11 strains with MenB and MenC capsules warrant special consideration when formulating future non-capsular meningococcal vaccines.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The meningococcal ST-11 complex (cc11) is highly virulent and has caused large serogroup C and W outbreaks. |
• | Serogroup C to B capsular switching is concerning owing to a lack of a universal vaccine against serogroup B meningococci. |
• | Diverse serogroup B and C cc11 meningococci are predicted not to be covered by non-capsular vaccines targeting MenB. |
• | Dispensability of multiple antigens raises the prospect of vaccine-escape by potentially covered outbreak strains. |
• | Serogroup B and C cc11 meningococci merit special consideration when formulating future non-capsular meningococcal vaccines. |
Keywords : Neisseria meningitidis, Meningococcal, Serogroup B, ST-11 complex, Vaccine
Plan
Vol 75 - N° 2
P. 95-103 - août 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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