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Click here for Nimenrix® (meningococcal groups A, C, W-135 and Y conjugate vaccine) Prescribing Information for Great Britain (GB) and Northern Ireland (NI). Click here for Trumenba®▼ (meningococcal group B vaccine (recombinant, adsorbed)) Prescribing Information for GB and NI.
Adverse event reporting information can be found at the bottom of the page.

Meningococcal Disease - mechanism of diseaseMeningococcal Disease - mechanism of disease

Meningococcal disease refers to any illness caused by bacteria called Neisseria meningitidis. N. meningitidis is found only in humans.1

To cause disease, the bacterium must survive in the bloodstream, where it has to avoid being killed by host innate immune mechanisms, particularly the complement system.2 It is able to do this through it's unique structure of both an inner (cytoplasmic) membrane and an outer membrane, separated by a cell wall. These structures house the outer membrane surface proteins and the capsular polysaccharide that comprise the main surface antigens of the organism.3 These antigens are the targets of immunological activity from the host organism.

N. meningitidis uses the polysaccharide capsule to evade destruction by the immune system, using a protective shell to prevent binding of the complement system that could otherwise initiate lysis and phagocytosis. The complement-bacterium complex is called the C3b.4 Evasion can be enhanced by other methods including mimicry of host molecules, recruiting factor H and its

genetic diversity.

Figure 1: Polysaccharide capsule mechanism. Adapted from Tan LKK, Carlone GM, Borrow R. Advances in the development of vaccines against Neisseria meningitidis. N Engl J Med. 2010; 362:1511-20.

PfizerPro Learn more about Nimenrix

Nimenrix (meningococcal groups A, C, W-135 and Y conjugate vaccine) is indicated for active immunisation of individuals from the age of 6 weeks against invasive meningococcal disease caused by Neiserria meningitidis serogroups A, C, W-135 and Y9

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Disease progression & SymptomsDisease progression & Symptoms

The incubation period of meningococcal disease is 3 to 4 days, with a range of 1 to 10 days. The rate at which the disease develops varies between patients.3
 

  1. The early symptoms (prodrome) could include fever, malaise, and lethargy.
  2. The classic symptoms that are more specific to meningitis are neck stiffness, severe headache, and photophobia.
  3. Comparatively, the symptoms of sepsis more commonly include limb/joint pain, pale/mottled blueish skin and tachycardia. Late features of Invasive Meningococcal Disease may include confusion, delirium, and impaired consciousness.6 
Burden of disease

Meningococcal disease is generally uncommon. In England, the national Public Health England (PHE) Meningococcal Reference Unit (MRU) confirmed 461 cases of IMD during 2019 to 2020.8 Focal meningococcal disease refers to disease within a localized area.3 This includes pneumonia, arthritis, otitis media, and epiglottitis.3 Whereas invasive meningococcal refers to disease that spreads in the body4, such as meningitis, septicaemia and bacteraemia.3

Immunisation & Treatment - history & advances

In 1906, scientists began to recommend anti-meningococcal serum therapy to protect humans against meningococcal disease; a therapy based on antibodies initially derived from the blood of horses, and later from patients, or individuals recovering from meningococcal disease. Antibiotics revolutionised treatment for meningitis however they do not always act fast enough to prevent damage that the bacteria can cause. The UK later introduced a conjugate vaccine against meningococcal disease with the MenC vaccine introduced in 1999.7

PfizerProFind out more about Trumenba

Trumenba (meningococcal group B vaccine (recombinant, adsorbed)) is indicated for active immunisation of individuals 10 years and older to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroup B.10

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References: 
1.    Rosenstein NE, Perkins BA, Stephens DS, Popovic T, Hughes JM. Meningococcal disease. N Engl J Med. 2001; 344(18):1378-1388.
2.    Schneider MC, Exley RM, Chan H, et al. Functional significance of factor H binding to Neisseria meningitidis. J Immunol. 2006; 176:7566-7575.
3.    United States Centers for Disease Control and Prevention (CDC). Meningococcal Disease. In: Hamborsky J, Kroger A, Wolfe S, eds, editors. Epidemiology and Prevention of Vaccine-Preventable Diseases. 14th ed. Washington DC: Public Health Foundation; 2021.
4.    Panatto D, Amicizia D, Lai PL, Gasparini R. Neisseria meningitidis B vaccines. Exp Rev Vacc. 2011; 10(9):1337-1351.
5.    Tan LKK, Carlone GM, Borrow R. Advances in the development of vaccines against Neisseria meningitidis. N Engl J Med. 2010; 362:1511-20.
6.    Meningitis Research Foundation. Meningococcal Meningitis and Septicaemia Guidance Notes: Diagnosis and Treatment in General Practice. United Kingdom: Meningitis Research Foundation; 2018.
7.    Meningitis.org. 2020. The history of meningitis | Meningitis Research Foundation. [online] Available at: https://www.meningitis.org/blogs/the-history-of-meningitis [Accessed May 2022]. 
8.    Assets.publishing.service.gov.uk. 2021. [online] Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/951142/hpr0121_imd-ann.pdf [Accessed May 2022].
9.    Nimenrix. Summary of Product Characteristics, Great Britain, Pfizer Ltd. Available here [Accessed May 2022].
10.  Trumenba. Summary of Product Characteristics, Great Britain, Pfizer Ltd. Available at: https://www.medicines.org.uk/emc/product/2670 [Accessed May 2022].
PP-UNP-GBR-0743 May 2022

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Adverse events should also be reported to Pfizer Medical Information on 01304 616161

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