Immunization for meningococcal serogroup B - What does the practitioner need to know? Flashcards

1
Q

How many serogroups of Neisseria meningitidis are there?

A

12 determined by the polysaccharide capsule

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2
Q

Which serogroups cause most invasive meningococcal disease?

A

A, B, C, Y, and W

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3
Q

Which serogroups are routinely immunized in infancy?

A

All provinces C

Alberta, Saskatchewan, Ontario, NB, PEI, Nfld quadrivalent (A,C,Y,W) conjugate vaccine

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4
Q

What is the most prevalent serogroup in Canada?

A

B (>50% of cases)

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5
Q

What are the four components in 4CMenB?

A
  1. Neisserial heparin-binding antigen (NHBA)
  2. Factor H-binding protein (fHbp)
  3. Neisserial adhesion A (NadA)
  4. PorA (the most immunogenic protein from the outer membrane vesicles)
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6
Q

What percentage of Canadian meningitis B strains would be covered by 4CMenB?

A

66% of strains

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7
Q

What is the effectiveness of 4CMenB?

A

Estimates of effectiveness are still very tentative

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8
Q

How many does are required?

A

2m, 4m,, and 6m

Likely will require boosters

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9
Q

What adverse effects are associated with 4CMenB?

A
  1. Fever in 65% of infants, may result in FSWU in children at 2m
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10
Q

What is the NNT for 4CMenB?

A

As infants younger than 6m will remain unprotected 1 in 141 000
10-20 times that number to prevent one death

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11
Q

Who should receive 4CMenB?

A
  1. Asplenia
  2. Hyposplenism
  3. Congenital complement deficiency
  4. Properdin deficiency
  5. Factor D deficiency
  6. Primary antibody deficiency
  7. > 1 episode of invasive meningococcal disease
  8. Laboratory personnel working with the organism
  9. Consider with eculizumab >2wks prior to the first dose or within 1 week post-eculizumab as risk of hemolysis
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