PROSPECTS FOR PREVENTION OF BACTERIAL-MENINGITIS WITH POLYSACCHARIDE VACCINES

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  • 1 January 1978
    • journal article
    • research article
    • Vol. 56  (4) , 509-518
Abstract
Most suppurative infections of the meninges are caused by 5 bacterial species: Escherichia coli, Haemophilus influenzae type b, Streptococcus pneumoniae, Neisseria meningitidis, and group B Streptococcus. The immune response of adults to pneumococcal capsular polysaccharides was studied in great detail and their responses to meningococcal and H. influenzae type b capsular polysaccharides are quite similar. Immune responses of adults to E. coli and group B streptococcal antigens are disappointing. The responses of children below the age of 7 yr differ quantitatively and in duration. Early experience shows that useful antibody titers can be achieved with certain antigens but further studies are required. To prevent bacterial meningitis by immunization, 3 vaccine formulations will need to be developed. When epidemic meningococcal disease occurs in a population, the vaccine containing only components of the meningococcus would be applied to a large segment of the population to terminate the epidemic. The 2nd vaccine would contain components of H. influenzae type b, pneumococcus and the meningococcus and would be administered in the 1st yr of life and repeated at suitable intervals to maintain life-long immunity. The 3rd vaccine, designed to prevent neonatal meningitis caused by E. coli K1 and group B streptococci, would be administered to women preferably during the 3rd trimester of pregnancy, so that their offspring would inherit sufficient antibodies to protect them, during the first 3 mo. of life. The vaccine against the meningococcus is a reality and was used extensively during major epidemics, with excellent results. The 2 vaccines for control of endemic bacterial meningitides do not exist as yet, but the prospects are good.