The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Figures & data

Table 1. GMI global recommendations

1. Country‐specific approaches to vaccine prevention are needed because of disease variation.

2. Country‐specific meningococcal policy should be based on local epidemiology and economic considerations.

3. Continued funding of the introduction of MenAfriVac® is an important global and regional public health priority.

4. The Meningitis Vaccine Project (MVP) model should be considered when developing other products with markets that are primarily or exclusively in low- to middle-income countries.

5. Travelers to high‐risk areas should be vaccinated against MD according to recommendations by public health authorities.

6. Vaccines against all clinically relevant serogroups (A, B, C, W, X, and Y) should be developed.

7. Conjugate vaccines should replace polysaccharide vaccines whenever cost, availability, licensing, and immunization policy allow. However, polysaccharide vaccines are still recommended where conjugate vaccines are not available.

8. Laboratory‐based surveillance for IMD should be strengthened (or initiated) to determine the true burden of disease.

9. Local public health authorities should assess the value of issuing an advisory for those attending a planned mass gathering event to be vaccinated based on available epidemiologic evidence.

10. Vaccination of individuals who are HIV positive.

Figure 1. Geo-temporal distribution of isolates within distal sublineages of meningococcal lineage 11.1.The inset (top-right) depicts a cgMLST (1546 loci) neighbor-net phylogenetic network of all 750 geo-temporally diverse cc11 isolates and two non-cc11 isolates (cc8 and cc41/44) highlighting the distal region of lineage 11.1 that bifurcates into two sublineages. Isolates corresponding to this region underwent a separate cgMLST (1546 loci) comparison to generate the neighbor-net network in the main figure. Both sublineages contained several clusters, each relating to a noteworthy episode of MenW disease. One lineage included the strain relating to the Hajj outbreak of 2000 onwards (Anglo-French Hajj strain), the expansion of endemic MenW:cc11 disease in South Africa from 2003 (endemic South African Strain) and a period of MenW:cc11 epidemics in sub-Saharan Africa (Burkina Faso/North African Strains). The other sublineage contained clusters relating to expanding endemic MenW:cc11 disease in South America and the U.K. (the South American/U.K. strain). Dots relate to individual cases. The scale bar indicates the number of loci differing among the 1546 compared. Figure adapted from Figure 3 of Ref. [37] and reprinted from Journal of Infection, Vol 71/Issue 5, J Lucidarme, DM Hill, HB Bratcher, et al. Genomic resolution of an aggressive, widespread, diverse and expanding meningococcal serogroup B, C and W lineagep. 549, 2015, with permission from Elsevier

Figure 2. Incidence of MenW in the U.K. from 2011/2012 to 2016/2017 [99]

Figure 3. Incidence of N. gonorrhoeae vs. N. meningitidis in Cuba (1978–2016) [130]

Lucidarme J, Hill DM, Bratcher HB, et al. Genomic resolution of an aggressive, widespread, diverse and expanding meningococcal serogroup B, C and W lineage. J Infect. 2015;71(5):544–552.

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