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Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story
The epidemiology of meningococcal disease in Canada has been punctuated by outbreaks caused by serogroup A strains in the 1940s, virulent serogroup C clones from 1985 to 2001, a serogroup B clone in Quebec from 2003 to 2014, and more recently a W clone in British Columbia. Region- and province-wide...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Hindawi
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899262/ https://www.ncbi.nlm.nih.gov/pubmed/31885753 http://dx.doi.org/10.1155/2019/8901847 |
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author | De Wals, Philippe |
author_facet | De Wals, Philippe |
author_sort | De Wals, Philippe |
collection | PubMed |
description | The epidemiology of meningococcal disease in Canada has been punctuated by outbreaks caused by serogroup A strains in the 1940s, virulent serogroup C clones from 1985 to 2001, a serogroup B clone in Quebec from 2003 to 2014, and more recently a W clone in British Columbia. Region- and province-wide immunization campaigns have been implemented to control these outbreaks using meningococcal C polysaccharide and conjugate vaccines, a quadrivalent ACWY conjugate vaccine, and a serogroup B protein-based vaccine. Meningococcal C conjugate vaccines have been included in routine immunization programs for children, and ACWY conjugate vaccines have been included in school-based programs for adolescents in most jurisdictions. In contrast, serogroup B protein-based vaccines were only recommended and used for high-risk individuals and to control outbreaks. Currently, the immunization schedules adopted in provinces and territories are not uniform. This is not explained by notable epidemiologic differences. Publicly funded immunization programs are the result of a complex decision-making process. Political factors including public opinion, media attention, interest groups' advocacy campaigns, decision-makers' priorities and budgetary constraints have played important roles in shaping meningococcal programs in Canada, and this should be recognized. As the recent occurrence of outbreaks caused by virulent W clones shows, continued investments in epidemiological surveillance at both the provincial and national levels are necessary, so there can be early warning and informed decisions can be made. |
format | Online Article Text |
id | pubmed-6899262 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-68992622019-12-29 Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story De Wals, Philippe Can J Infect Dis Med Microbiol Review Article The epidemiology of meningococcal disease in Canada has been punctuated by outbreaks caused by serogroup A strains in the 1940s, virulent serogroup C clones from 1985 to 2001, a serogroup B clone in Quebec from 2003 to 2014, and more recently a W clone in British Columbia. Region- and province-wide immunization campaigns have been implemented to control these outbreaks using meningococcal C polysaccharide and conjugate vaccines, a quadrivalent ACWY conjugate vaccine, and a serogroup B protein-based vaccine. Meningococcal C conjugate vaccines have been included in routine immunization programs for children, and ACWY conjugate vaccines have been included in school-based programs for adolescents in most jurisdictions. In contrast, serogroup B protein-based vaccines were only recommended and used for high-risk individuals and to control outbreaks. Currently, the immunization schedules adopted in provinces and territories are not uniform. This is not explained by notable epidemiologic differences. Publicly funded immunization programs are the result of a complex decision-making process. Political factors including public opinion, media attention, interest groups' advocacy campaigns, decision-makers' priorities and budgetary constraints have played important roles in shaping meningococcal programs in Canada, and this should be recognized. As the recent occurrence of outbreaks caused by virulent W clones shows, continued investments in epidemiological surveillance at both the provincial and national levels are necessary, so there can be early warning and informed decisions can be made. Hindawi 2019-11-25 /pmc/articles/PMC6899262/ /pubmed/31885753 http://dx.doi.org/10.1155/2019/8901847 Text en Copyright © 2019 Philippe De Wals. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article De Wals, Philippe Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story |
title | Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story |
title_full | Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story |
title_fullStr | Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story |
title_full_unstemmed | Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story |
title_short | Epidemiology and Control of Meningococcal Disease in Canada: A Long, Complex, and Unfinished Story |
title_sort | epidemiology and control of meningococcal disease in canada: a long, complex, and unfinished story |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899262/ https://www.ncbi.nlm.nih.gov/pubmed/31885753 http://dx.doi.org/10.1155/2019/8901847 |
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