Abstract
BackgroundBaseline hospitalization, mortality, and in-hospital fatality rates for meningococcal infection are required to evaluate preventive interventions, such as the inclusion of the conjugated quadrivalent meningococcal vaccine and serogroup B based protein vaccines.MethodsAll meningococcal infection–related hospitalizations in any diagnostic position in Spain from 1st January 1997 through 31st December 2018 were analysed. The annual hospitalization rate, mortality rate and case-fatality rate were calculated.ResultsThe average hospitalization rate for meningococcal infection was 1.64 (95% CI 1.61 to 1.66) hospitalizations per 100,000 inhabitants during the study period and significantly decreased from 1997 to 2018. Hospitalizations for meningococcal infection decreased significantly with age and were concentrated in children under 5 years of age (46%). The hospitalization rates reached 29 per 100,000 and 24 per 100,000 children under 1 and 2 years of age, respectively. The in-hospital case-fatality rate was 7.45% (95% CI 7.03 to 7.86). Thirty percent of the deaths occurred in children under 5 years of age, and more than half occurred in adults. The case fatality rate increased significantly with age (p < 0.001).ConclusionIt is necessary to maintain epidemiological surveillance of meningococcal infection to determine the main circulating serogroups involved, track their evolution, and evaluate preventive measures whose effectiveness must be assessed in all age groups.
Highlights
Baseline hospitalization, mortality, and in-hospital fatality rates for meningococcal infection are required to evaluate preventive interventions, such as the inclusion of the conjugated quadrivalent meningococcal vaccine and serogroup B based protein vaccines
These vaccines contain a polysaccharide molecule chemically conjugated to a T cell–stimulating antigen, such as a diphtheria toxoid or tetanus, increasing their immunogenicity, which has led to the achievement of immunogenicity in infants from 2 months of age, the establishment of immune memory, and the prevention of acquisition of carriage, which are important advantages that have led to herd immunity through reduced carrier status [4, 5]
The latest vaccine for meningococcus is generated by reverse vaccination for serogroup B, which is immunogenic and safe to use in children older than 2 months, adolescents, and adults [6,7,8,9]
Summary
Mortality, and in-hospital fatality rates for meningococcal infection are required to evaluate preventive interventions, such as the inclusion of the conjugated quadrivalent meningococcal vaccine and serogroup B based protein vaccines. Polysaccharide vaccines, effective and safe in the short term, have several deficiencies They offer little or no immunogenicity in children under 2 years of age, do not generate immunological memory and are ineffective when the recipient is a carrier [3]. The development of conjugate vaccines in the 1990s spurred a breakthrough in meningococcal vaccination These vaccines contain a polysaccharide molecule chemically conjugated to a T cell–stimulating antigen, such as a diphtheria toxoid or tetanus, increasing their immunogenicity, which has led to the achievement of immunogenicity in infants from 2 months of age, the establishment of immune memory, and the prevention of acquisition of carriage, which are important advantages that have led to herd immunity through reduced carrier status [4, 5]. The latest vaccine for meningococcus is generated by reverse vaccination for serogroup B, which is immunogenic and safe to use in children older than 2 months, adolescents, and adults [6,7,8,9]
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