Meningococcal vaccine in travelers.
OBJECTIVE
New vaccines to prevent meningococcal disease have been licensed in recent years. It is therefore timely to discuss current vaccine strategies pertinent to international travelers in relation to the changing epidemiology.


RESULTS
Serogroup W135 achieved epidemic status in Africa in 2002, and then largely disappeared over a short time period. The year 2006 saw a marked epidemic rise in meningitis attack rates across the meningitis belt in Africa. This rise was mainly due to a new serogroup A strain, indicating that a new meningitis epidemic wave is beginning in Africa. Epidemics are also spreading south of the meningitis belt, including the Greater Lakes Area (Burundi, Rwanda, Republic of Tanzania). The new quadrivalent conjugate meningococcal vaccine is now licensed in North America but not elsewhere. In most other industrialized countries, the serogroup C conjugate vaccine is licensed. Plain polysaccharide quadrivalent vaccines are available almost worldwide.


CONCLUSIONS
Quadrivalent meningococcal vaccination is a visa requirement for Hajj and Umrah pilgrims to Saudi Arabia. Travelers to the meningitis belt during the dry season should be advised to receive meningococcal vaccine that covers all four serogroups. This recommendation should be extended to the Greater Lake Area, because of recent epidemics. Vaccine choices depend on availability.
Wilder-Smith
Annelies
A
Department of Medicine, National University Singapore, Singapore. epvws@pacific.net.sg
D000349:Africa / Q000453:epidemiology; D000367:Age Factors; D001208:Asia / Q000453:epidemiology; D004196:Disease Outbreaks; D006801:Humans; D017589:Immunization Programs; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D022401:Meningococcal Vaccines; D008877:Middle East / Q000453:epidemiology; D009345:Neisseria meningitidis / Q000145:classification / Q000276:immunology; D012703:Serotyping; D014195:Travel; D018074:Vaccines, Conjugate
D022401:Meningococcal Vaccines; D018074:Vaccines, Conjugate