MeNZB

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MeNZB
Vaccine description
Targetgroup B meningococcus strain
Vaccine type Subunit
Clinical data
Routes of
administration
Injected
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Identifiers
CAS Number
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MeNZB was a vaccine against a specific strain of group B meningococcus, [1] used to control an epidemic of meningococcal disease in New Zealand. Most people are able to carry the meningococcus bacteria safely with no ill effects. However, meningococcal disease can cause meningitis and sepsis, resulting in brain damage, failure of various organs, severe skin and soft-tissue damage, and death.

Contents

Immunisation with MeNZB requires three doses, administered approximately six weeks apart (except in newborns, who have them in conjunction with their 6-week, 3-month and 5-month injections). People who have been fully immunised may still carry the meningococcus bacteria and may still contract meningococcal disease.

Components

Each dose is 0.5 ml and contains:

The antigen in MeNZB is prepared from B:4:P1.7b,4 (NZ 98/254 ) N. meningitidis strain, grown in a fermentor. The bacteria are grown in a synthetic culture medium containing sugar, essential amino acids and essential elements such as iron and potassium. The fermentation does not use bovine or porcine products. The cellular outer membranes are extracted with the detergent deoxycholate, which kills the bacteria. Outer membrane vesicles are purified out of the culture medium by ultracentrifugation, stabilised by histidine and then adsorbed to aluminium hydroxide Al(OH)3 as an adjuvant. Purification is achieved by ultrafiltration/diafiltration.

Impact

Since its introduction in 2004 the vaccine has had a dramatic impact on the meningitis epidemic began in 1991. [2] Between 2004 and 2006 New Zealand offered free MeNZB vaccination to anyone under the age of 20. Routine immunisation for babies and preschoolers continued until June 2008. The last phase of this programme, immunisation for people with a high medical risk, ended in March 2011. [3] Reasons given for this halt of the programme include that the epidemic was coming to an end, and that immune protection given by the vaccine is only short-term. [4] The primary analysis estimated MeNZB to have an effectiveness of 77% after 3 doses and a mean follow-up time of 3.2 years. [5]

As N. gonorrhoeae and N. meningitidis are closely related bacteria and have 80–90% homology in their genetic sequences some cross-protection by meningococcal vaccines against N. gonorrhoeae infections is plausible. A study published in 2017 showed that MeNZB vaccine provided a partial protection against Gonorrhea. [6] The vaccine efficiency was calculated to be 31%. [7]

Related Research Articles

<i>Neisseria gonorrhoeae</i> Species of bacterium

Neisseria gonorrhoeae, also known as gonococcus (singular), or gonococci (plural), is a species of Gram-negative diplococci bacteria isolated by Albert Neisser in 1879. It causes the sexually transmitted genitourinary infection gonorrhea as well as other forms of gonococcal disease including disseminated gonococcemia, septic arthritis, and gonococcal ophthalmia neonatorum.

Waterhouse–Friderichsen syndrome Medical condition

Waterhouse–Friderichsen syndrome (WFS) is defined as adrenal gland failure due to bleeding into the adrenal glands, commonly caused by severe bacterial infection. Typically, it is caused by Neisseria meningitidis.

<i>Neisseria</i> Genus of bacteria

Neisseria is a large genus of bacteria that colonize the mucosal surfaces of many animals. Of the 11 species that colonize humans, only two are pathogens, N. meningitidis and N. gonorrhoeae. Most gonococcal infections are asymptomatic and self-resolving, and epidemic strains of the meningococcus may be carried in >95% of a population where systemic disease occurs at <1% prevalence.

Lipopolysaccharide Class of molecules found in the outer membrane of Gram-negative bacteria

Lipopolysaccharides (LPS) are large molecules consisting of a lipid and a polysaccharide. They are composed of an O-antigen, an outer core, and an inner core all joined by a covalent bonds, and are found in the outer membrane of Gram-negative bacteria. Today, the term endotoxin is often used synonymously with LPS, although there are a few endotoxins that are not related to LPS, such as the so-called delta endotoxin proteins produced by Bacillus thuringiensis.

Bacterial capsule Polysaccharide layer that lies outside the cell envelope in many bacteria

The bacteria capsule is a large structure common to many bacteria. It is a polysaccharide layer that lies outside the cell envelope, and is thus deemed part of the outer envelope of a bacterial cell. It is a well-organized layer, not easily washed off, and it can be the cause of various diseases.

<i>Neisseria meningitidis</i> Species of bacterium that can cause meningitis

Neisseria meningitidis, often referred to as meningococcus, is a Gram-negative bacterium that can cause meningitis and other forms of meningococcal disease such as meningococcemia, a life-threatening sepsis. The bacterium is referred to as a coccus because it is round, and more specifically a diplococcus because of its tendency to form pairs.

Meningococcal disease Medical condition

Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis. It has a high mortality rate if untreated but is vaccine-preventable. While best known as a cause of meningitis, it can also result in sepsis, which is an even more damaging and dangerous condition. Meningitis and meningococcemia are major causes of illness, death, and disability in both developed and under-developed countries.

Charlotte Cleverley-Bisman

Charlotte Lucy Cleverley-Bisman is a child known as the face of a New Zealand campaign to encourage vaccination against meningococcal disease after contracting and surviving severe meningococcal sepsis. She was nicknamed "Miraculous Baby Charlotte" by her fellow New Zealanders as a result of making headlines worldwide after recuperating from a series of life-threatening complications. She is the daughter of Pam Cleverley and Perry Bisman.

Gonorrhea Sexually transmitted infection

Gonorrhea, colloquially known as the clap, is a sexually transmitted infection (STI) caused by the bacterium Neisseria gonorrhoeae. Infection may involve the genitals, mouth, or rectum. Infected men may experience pain or burning with urination, discharge from the penis, or testicular pain. Infected women may experience burning with urination, vaginal discharge, vaginal bleeding between periods, or pelvic pain. Complications in women include pelvic inflammatory disease and in men include inflammation of the epididymis. Many of those infected, however, have no symptoms. If untreated, gonorrhea can spread to joints or heart valves.

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Meningitis Inflammation of the membranes around the brain and spinal cord

Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, nausea, vomiting, and an inability to tolerate light or loud noises. Young children often exhibit only nonspecific symptoms, such as irritability, drowsiness, or poor feeding. A non-blanching rash may be present.

Meningococcal vaccine Vaccines used to prevent infection by Neisseria meningitidis

Meningococcal vaccine refers to any vaccine used to prevent infection by Neisseria meningitidis. Different versions are effective against some or all of the following types of meningococcus: A, B, C, W-135, and Y. The vaccines are between 85 and 100% effective for at least two years. They result in a decrease in meningitis and sepsis among populations where they are widely used. They are given either by injection into a muscle or just under the skin.

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<i>Neisseria flavescens</i> Species of bacterium

Neisseria flavescens was first isolated from cerebrospinal fluid in the midst of an epidemic meningitis outbreak in Chicago. These gram-negative, aerobic bacteria reside in the mucosal membranes of the upper respiratory tract, functioning as commensals. However, this species can also play a pathogenic role in immunocompromised and diabetic individuals. In rare cases, it has been linked to meningitis, pneumonia, empyema, endocarditis, and sepsis.

Sir Andrew John Pollard is a Professor of Paediatric Infection and Immunity at the University of Oxford and a Fellow of St Cross College, Oxford. He is an Honorary Consultant Paediatrician at John Radcliffe Hospital and the Director of the Oxford Vaccine Group. He is the Chief Investigator on the University of Oxford COVID-19 Vaccine trials and has led research on vaccines for many life-threatening infectious diseases including typhoid fever, Neisseria meningitidis, Haemophilus influenzae type b, streptococcus pneumoniae, pertussis, influenza, rabies, and Ebola.

Helen Aspasia Petousis-Harris is a New Zealand vaccinologist and associate professor in the Department of General Practice and Primary Health Care at the University of Auckland. She has been involved in research related to vaccination in New Zealand since 1998, with her main areas of focus being vaccine safety and effectiveness. Petousis-Harris has had a variety of lead roles in New Zealand and international organisations that focus on vaccination and is a regular media spokesperson in this field, especially during the COVID-19 pandemic.

Diana Martin (scientist) New Zealand microbiologist (1942–2019)

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References

  1. Loring BJ, Turner N, Petousis-Harris H (November 2008). "MeNZB vaccine and epidemic control: when do you stop vaccinating?". Vaccine. 26 (47): 5899–904. doi:10.1016/j.vaccine.2008.08.062. PMID   18804134.
  2. Holst J, Martin D, Arnold R, et al. (June 2009). "Properties and clinical performance of vaccines containing outer membrane vesicles from Neisseria meningitidis". Vaccine. 27 Suppl 2: B3–12. doi:10.1016/j.vaccine.2009.04.071. PMID   19481313.
  3. Ministry of Health website, https://www.health.govt.nz/our-work/preventative-health-wellness/immunisation/immunisation-programme-decisions/meningococcal-b-immunisation-programme-and-menzbtm-vaccine
  4. Ministry of Health statement, http://www.health.govt.nz/news-media/media-releases/menzb-vaccine-helped-curb-epidemic%5B%5D
  5. Meningococcal: New Insights for the Healthcare Professional: 2012 Edition: ScholarlyBrief. ScholarlyEditions. 10 December 2012. p. 51. ISBN   978-1-4649-7337-6.
  6. Gottlieb, Sami L.; Johnston, Christine (2017). "Future prospects for new vaccines against sexually transmitted infections". Curr Opin Infect Dis. 30 (1): 77–86. doi:10.1097/QCO.0000000000000343. PMC   5325242 . PMID   27922851.
  7. Petousis-Harris, Helen (2017). "Effectiveness of a group B outer membrane vesicle meningococcal vaccine against gonorrhoea in New Zealand: a retrospective case-control study". Lancet. 390 (10102): 1603–1610. doi:10.1016/S0140-6736(17)31449-6. PMID   28705462. S2CID   4230156.