A vaccine (Trumenba) for invasive meningococcal disease was approved by the United States Food and Drug Administration (FDA) today, October 29, 2014. Meningococcal disease is caused by the bacteria Neisseria meningitidis. A meningococcal polysaccharide vaccine (MPSV) was licensed in 1981 that protects against four of the five main subtypes of meningococcus – A, C, Y, and W. However, Trumenba is the first vaccine to be licensed in the United States that protects against subtype B, which causes nearly one third of all the meningococcus cases in the United States.
According to the Centers for Disease Control and Prevention (CDC), about 500 total cases of meningococcal disease were reported in the United States in 2012; the Connecticut Department of Public Health reported four cases of meningococcal disease in Connecticut in 2012. “Recent outbreaks of [subtype] B Meningococcal disease on a few college campuses have heightened concerns for this potentially deadly disease,” said Karen Midthun, M.D., of the FDA. “The FDA’s approval of Trumenba provides a safe and effective way to help prevent this disease in the United States.”
Meningococcal disease is more common in other parts of the world, particularly in Africa which is known as the “meningitis belt”. Approximately 700,000 cases of meningococcal disease occurred in this area over a recent 10-year period. Subtype A is responsible for most of the meningococcal disease in sub-Saharan Africa. The epidemiology of meningococcal disease in the United States has changed dramatically over the past hundred years. Large outbreaks of meningococcal disease caused by subtype A were common during the first half of the twentieth century. Today, subtype A disease is very uncommon in the United States, while subtype Y disease has become more common. And most recently, outbreaks of subtype B meningococcal disease have been seen on college campuses (Princeton; The University of California, Santa Barbara).
Certain people are at greater risk for meningococcal disease. Meningococcal disease is more common among infants, adolescents, and young adults. And since infectious diseases tend to spread quickly wherever large groups gather together, first-year college students living in residence halls are at slightly increased risk compared with others of the same age. Additionally, travelers to the meningitis belt in sub-Saharan Africa may be at risk for meningococcal disease.
A common outcome of meningococcal infection is meningitis. When someone has meningococcal meningitis (that is, meningitis caused by meningococcal bacteria), the protective membranes covering their brain and spinal cord, known as the meninges, become infected and swell. The symptoms of meningococcal meningitis typically develop within 3-7 days after exposure. The “hallmark” symptoms include sudden onset of fever, headache, and stiff neck. There are often additional symptoms, such as:
- Photophobia (increased sensitivity to light)
- Altered mental status (confusion)
Meningococcal disease is a life-threatening illness. Early diagnosis and treatment are key. But, the best defense is prevention.