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August 8, 2001

Toward Control of Meningococcal Disease: Reducing Risk in College Students

Author Affiliations

Author Affiliation: Expanded Programme on Immunization, World Health Organization, Geneva, Switzerland.

JAMA. 2001;286(6):720-721. doi:10.1001/jama.286.6.720

Neisseria meningitidis can cause rapid onset of meningitis and sepsis, leading to death or permanent disability. Meningococcal disease occurs globally, and while the largest outbreaks and preponderance of mortality and morbidity occur in the developing world, the disease continues to strike the young in developed countries.

The N meningitidis organism is usually classified in terms of serogroup, referring to the antigenic properties of the capsular polysaccharide. Most disease in the developed world is caused by organisms of serogroups B, C, Y, and W135 while serogroup A organisms cause the bulk of disease in the developing world.1 Vaccines prepared with polysaccharides from A, C, Y, and W135 organisms are safe, immunogenic, and have been shown to be effective, particularly in providing short-term and medium-term protection against outbreaks caused by serogroups A and C organisms.2 Serogroup B polysaccharide is not immunogenic. Preparation of vaccines from serogroup B proteins has been problematic, and efficacy of these products in young children, those at highest risk of disease, is disputed.2 Thus, prevention of meningococcal disease through vaccination has relied on the use of the polysaccharide vaccines that are available for some but not all strains.