Mortality from group C meningococcal disease: a case for a conjugate vaccine?
This 17-year retrospective review of children with meningococcal disease (MCD) has determined the mortality due to serogroup C, in order to assess the potential impact of a group C conjugate vaccine. Four hundred and forty-nine cases of MCD were admitted to our hospitals during 1977-1993; 78 due to group C, 11 of whom died. There was a significant increase in the proportion of cases due to group C from 1986 onwards (10% vs 21%), and an increase in the total number of cases of MCD (151 vs 298). The currently available group C polysaccharide vaccine has low efficacy below 2 years of age and could not have prevented 54 cases of group C disease. A conjugate group C vaccine administered between 2 and 4 months of age could have prevented 68 cases, including all fatal cases. The recent increase in MCD is partly due to an increase in group C disease. A meningococcal group C conjugate vaccine could prevent most cases of infection due to group C, and decrease the mortality from MCD by up to 30%.
Institute of Child Health, Alder Hey Children's Hospital, Liverpool, UK.
F A
FA
Riordan
O
O
Marzouk
A P
AP
Thomson
J A
JA
Sills
C A
CA
Hart
D000367:Age Factors; D001428:Bacterial Vaccines; D004739:England / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008589:Meningococcal Infections / Q000382:microbiology / Q000401:mortality* / Q000517:prevention & control*; D012189:Retrospective Studies; D018074:Vaccines, Conjugate
D001428:Bacterial Vaccines; D018074:Vaccines, Conjugate