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Vaccine. 2009 Jun 24;27 Suppl 2:B13-9. doi: 10.1016/j.vaccine.2009.04.062. Epub 2009 May 27.

Epidemic meningitis due to Group A Neisseria meningitidis in the African meningitis belt: a persistent problem with an imminent solution.

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  • 1PATH, 13 Chemin du Levant, Ferney-Voltaire 01210, France. fmlaforce@path.org


Epidemic meningitis in Africa remains an important and unresolved public health problem. Bacteriologic and epidemiologic data collected over the past 30 years have consistently established the importance of Group A Neisseria meningitidis as the dominant etiologic agent. The meningococcal Group A capsule is the major virulence factor; it is a polysaccharide comprised of a repeating unit of partly O-acetylated alpha-1,6-linked N-acetylmannosamine phosphate. Meningitis epidemics occur annually during the dry season (January to May) and stop with the first rains. Until now, control of these meningitis epidemics has relied on a reactive vaccination strategy with polysaccharide vaccines that is logistically complicated and has not put an end to recurrent epidemics. A meningococcal A conjugate vaccine (MenAfriVac) has been developed and tested in Phase II clinical trials in Africa. The vaccine has been shown to be safe and to generate a sustained immunologic response with functional antibody 20 times higher than that seen with polysaccharide vaccine. Widespread use of such a vaccine is likely to generate herd immunity and to put an end to Group A meningococcal epidemics.

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