meningococcal conjugate vaccine :: Article CreatorReport Shows Rise In Meningococcal Disease Cases Among People With HIV In 2022
Preliminary data suggest the number of meningococcal disease cases among individuals with HIV doubled in 2022, while vaccination rates for the disease remain low.
There has been a concerning increase in meningococcal disease cases among individuals living with HIV in the United States over the past few years, according to the CDC's latest Morbidity and Mortality Weekly Report.
Meningococcal disease is a severe and potentially life-threatening illness caused by Neisseria meningitidis bacteria, typically manifesting as meningitis or meningococcemia. In the case of meningitis, it is characterized by symptoms such as fever, headache, and a stiff neck, while meningococcemia presents with fever, chills, fatigue, vomiting, diarrhea, cold hands and feet, and severe aches or pain.
To combat the spread of meningococcal disease, the CDC's Advisory Committee on Immunization Practices (ACIP) recommends vaccination with the quadrivalent meningococcal conjugate vaccine (MenACWY) for adolescents and individuals at a heightened risk of contracting the disease, including individuals living with HIV.
In 2016, ACIP incorporated a 2-dose series of the vaccine into the US immunization schedule for individuals living with HIV. However, vaccination coverage among this population remains low. Research analyzing administrative claims data from January 2016 to March 2018 revealed that only 16.3% of individuals living with HIV received at least 1 dose of the MenACWY vaccine within 2 years of receiving their diagnosis.
The current report demonstrates an increase in meningococcal disease among people with HIV in 2022, according to the authors. They also explained, as data are typically finalized in fall of the next year—in this case, fall 2023—this report is based on preliminary data for 2022.
The National Notifiable Diseases Surveillance System is responsible for collecting meningococcal disease case reports, and Enhanced Meningococcal Disease Surveillance reports provide additional epidemiologic information and isolates for analysis. By utilizing whole genome sequencing, isolates are thoroughly examined to determine serogroup and molecular typing information.
Looking at data between 2017 and 2021, there were typically 5 to 15 cases of meningococcal disease reported each year among individuals with HIV, accounting for 1.5% to 4.3% of all US cases annually. However, preliminary data for 2022 indicate a substantial increase, with 29 meningococcal disease cases reported among individuals with HIV, reflecting 9.8% of the total cases. It's important to note that this number may further increase as reporting becomes more comprehensive.
Among those 29 reported cases, 22 individuals had not received the MenACWY vaccine, 6 had an unknown vaccination history, and 1 had received the vaccine, but the number of doses was unclear.
Notably, 15 individuals with meningococcal disease were part of a larger serogroup C primarily affecting men who have sex with men (MSM). However, even after excluding the MSM outbreak-associated cases from the analysis, 2022 still saw a significant increase in meningococcal disease cases among individuals with HIV, with 14 cases compared with 4 to 8 annual cases between 2017 and 2021.
Among the other 14 cases not linked to the MSM outbreak, 9 were caused by a single strain of N meningitidis belonging to serogroup Y, clonal complex CC174 sequence type ST-1466. Eight of these cases occurred in Black or African American individuals, with 7 of these patients being MSM. Interestingly, these 9 cases caused by the same strain were reported across 3 states with no identified connections, the authors noted. The other 5 cases were not geographically clustered, and any epidemiologic connections have yet to be identified.
"MenACWY vaccine coverage among persons with HIV is low; given the recent increase in meningococcal disease cases in this population, health care providers should ensure that all persons with HIV are up to date with MenACWY vaccination per ACIP recommendations, as well as other vaccines recommended for this population," the report authors said. "Health care providers should also maintain a high index of suspicion for meningococcal disease among persons with HIV who have symptoms of meningococcal disease."
The authors reminded of the CDC recommendation that everyone should be screened for HIV at least once in their lifetime, and called on providers to ensure their patients with meningococcal disease are screened for HIV if their status in unknown.
Reference
Rubis AB, Howie RL, Marasini D, Sharma S, Marjuki H, McNamara LA. Notes from the field: increase in meningococcal disease among persons with HIV - United States, 2022. MMWR Morb Mortal Wkly Rep. 2023;72(24):663-664. Doi:10.15585/mmwr.Mm7224a4
Erie's Public Schools, Community Health Net To Host Immunization Clinic
Erie's Public Schools and Community Health Net will be holding an immunization clinic on August 1st.
The health clinic will be held a location to be determined near East Middle School.
Erie's Public Schools said the event is a fantastic opportunity to make sure your child has all of the necessary immunizations before the start of the 2023-24 school year.
Pennsylvania students entering the 7th grade are required to have the following immunizations:
1 dose of tetanus, diphtheria , acellular pertussis (Tdap) 1 dose of meningococcal conjugate vaccine (MCV) Pennsylvania students entering the 12th grade are required to have the following immunizations:
A second dose of meningococcal conjugate vaccine (MCV). If one doses was given at 16 years of age or older, that shall count as the 12th grade dose. Pennsylvania students of all grades are required to have the following immunizations:
4 doses of tetanus, diphtheria, and acellular pertussis (1 dose on or after the 4th birthday) 4 doses of polio (4th dose on or after 4th birthday and at least 6 months after previous dose given) 2 doses of measles, mumps, rubella 3 doses of hepatitis B 2 doses of varicella (chickenpox) or evidence of immunity More information can be found here.
Meningococcal Disease Cases Up In Persons With HIV In 2022
In 2022, there was an increase in meningococcal disease among persons with HIV, with 29 cases reported, accounting for 9.8 percent of all meningococcal disease cases, according to research published in the June 16 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.
Noting that persons with HIV have low coverage of quadrivalent meningococcal conjugate vaccination (MenACWY), Amy B. Rubis, M.P.H., from the CDC in Atlanta, and colleagues used preliminary data for 2022 to describe meningococcal disease cases among persons with HIV in the United States.
The researchers found that there were five to 15 meningococcal disease cases reported each year among persons with HIV during 2017 to 2021, representing 1.5 to 4.3 percent of all meningococcal disease cases annually. In 2022, 29 meningococcal disease cases were reported based on preliminary data, accounting for 9.8 percent of all cases. When reporting is complete, this case count could increase.
Of the 29 meningococcal disease cases, 22 had not received MenACWY vaccine, six had unknown vaccine history, and one had received MenACWY vaccine (unknown number of doses).
"Health care providers should ensure that all persons with HIV are up to date with MenACWY vaccination per Advisory Committee on Immunization Practices recommendations, as well as other vaccines recommended for this population," the authors write.
More information: Amy B. Rubis et al, Notes from the Field: Increase in Meningococcal Disease Among Persons with HIV—United States, 2022, MMWR. Morbidity and Mortality Weekly Report (2023). DOI: 10.15585/mmwr.Mm7224a4 www.Cdc.Gov/mmwr/volumes/72/wr … htm?S_cid=mm7224a4_w
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Citation: Meningococcal disease cases up in persons with HIV in 2022 (2023, June 16) retrieved 27 June 2023 from https://medicalxpress.Com/news/2023-06-meningococcal-disease-cases-persons-hiv.Html
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