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Invasive Meningococcal Disease (IMD)

IMD is caused by Neisseria meningitidis, a gram-negative aerobic diplococcus surrounded by a polysaccharide capsule and a strictly human pathogen. 1

Serogroups1:

  • 12 groups of N. meningitidis bacteria, called serogroups, have been identified based on variations in the biochemical composition of their polysaccharide capsules. 
  • The polysaccharide capsule is key in determining virulence. 2
  • 5 of these serogroups—A, B, C, W and Y—are responsible for most cases of IMD.

Clinical forms of IMD1:

The 3 main clinical forms are:

  • Meningitis ( an acute inflammation of the membranes that surrounds the brain and spinal cord), 
  • Meningococcal sepsis (infection of the bloodstream, also known as meningococcemia) and 
  • Pneumonia

Complications of IMD:

Although rare, IMD epidemiology is unpredictable, the disease is easily misdiagnosed, progressing rapidly and can be fatal or cause serious lifelong disabilities in survivors. 3456

  • Mortality rate:
    Between 5 to 10% of patients die, even with appropriate antibiotic therapy. 
    7
    It reaches up to 40% with meningococcemia. 1
  • Surviving IMD - Physical, cognitive and psychological sequelae: 16
    As many as 20% of survivors have permanent sequelae, such as, but not limited to brain damage, hearing loss, loss of a limb and learning difficulties.
    Parents of children with severe episodes of IMD have reported experiencing psychological distress for months and even years afterwards.

References:

  1. Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Chapter 14: Meningococcal Disease. Hamborsky J, Kroger A, Wolfe S, eds. 13th ed. Washington D.C. Public Health Foundation, 2015 
  2. Harrison LH, Trotter CL, Ramsay ME, Global epidemiology of meningococcal disease, Vaccine, 2009;27(Suppl2):B51-B63
  3. Rosenstein NE, Perkins BA, Stephens DS et al, Meningococcal Disease, N Engl J Med, 2001;344:1378-1388
  4. Caugant DA, Maiden MC, Meningococcal carriage and disease—Population biology and evolution, Vaccine, 2009;27(Suppl2):B64-B70
  5. Watson P, Turner D., Clinical experience with the meningococcal B vaccine, Bexsero®, Vaccine, 2016;34(7):875-880
  6. Ehrlich TR et al., Long-term psychological distress in parents of child survivors of severe meningococcal disease, Pediatr Rehabil., 2005;8(3):220-224
  7. World Health Organization (WHO). Meningococcal meningitis fact sheet No. 141, 2015. Available at: http://www.who.int/mediacentre/factsheets/fs141/en. Last accessed December 2016

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