Elsevier

Journal of Infection

Volume 81, Issue 5, November 2020, Pages 698-711
Journal of Infection

Review
Meningococcal disease surveillance in the Asia–Pacific region (2020): The global meningococcal initiative

https://doi.org/10.1016/j.jinf.2020.07.025Get rights and content
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open access

Highlights

  • Incidence of meningococcal disease is similar across the Asia–Pacific region.

  • The most prevalent serogroups of N. meningitidis are B, w and Y, with c also emerging.

  • Except for China and Australia, vaccination is not included in NIPs across the region.

  • Antibiotic resistance is an ongoing concern, with non-susceptible strains emerging.

  • A number of countries have adopted whole genome sequencing in surveillance programs.

Summary

The degree of surveillance data and control strategies for invasive meningococcal disease (IMD) varies across the Asia–Pacific region. IMD cases are often reported throughout the region, but the disease is not notifiable in some countries, including Myanmar, Bangladesh and Malaysia. Although there remains a paucity of data from many countries, specific nations have introduced additional surveillance measures. The incidence of IMD is low and similar across the represented countries (<0.2 cases per 100,000 persons per year), with the predominant serogroups of Neisseria meningitidis being B, W and Y, although serogroups A and X are present in some areas. Resistance to ciprofloxacin is also of concern, with the close monitoring of antibiotic-resistant clonal complexes (e.g., cc4821) being a priority. Meningococcal vaccination is only included in a few National Immunization Programs, but is recommended for high-risk groups, including travellers (such as pilgrims) and people with complement deficiencies or human immunodeficiency virus (HIV). Both polysaccharide and conjugate vaccines form part of recommendations. However, cost and misconceptions remain limiting factors in vaccine uptake, despite conjugate vaccines preventing the acquisition of carriage.

Keywords

Antibiotic resistance
Bacterial meningitis
Carriage
Conjugate vaccine
Asia-Pacific
Emerging strains
High-risk groups
Immunization program
Meningococcal disease
Neisseria meningitidis
Polysaccharide vaccine
Refugees
Serogroup
Surveillance
Vaccination

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