The evolution of meningococcal infection in Mongolia]

On the basis of the generalization and analysis of the results of bacteriological and immunological investigations the epidemic process of meningococcal infection (MI) in Mongolia was found to undergo definite changes during the last 20 years. Group A meningococci prevailing in the etiology of MI were replaced by strains belonging to group B affecting mainly young children (aged up to 3 years). MI morbidity rate caused by group B meningococci was found to be higher in Mongolia than in other countries of the world. These data substantiate the necessity of using more effective remedies for the control of this infection and, in particular, specific immunization with vaccines against group B meningococci; profound study of the properties of the circulating meningococcal strains is to be carried out.     

Epidemiological characteristics of meningococcal infection in a number of territories of the RSFSR (1969-1984)

In this work the dynamics and morbidity level in respect of meningococcal infection at 11 territories of the RSFSR at the period of 1969-1984 are analyzed. The study covered altogether 16 cities and 211 districts. The role of big cities as the sources of infection spreading into rural areas and further "fixation" of this infection mainly in regions with a population of 60,000 and more had been established. The data on meningococcal morbidity and carriership among different age groups are presented. The study has shown a pronounced increase in the incidence rate of meningococcal infection among children aged up to 2 years, as well as an increase in the proportion of these children among patients with meningococcal infection in recent years.     

Antibodies to meningococcal lipopolysaccharide in different forms of meningococcal infection

The results of the determination of antibodies to lipopolysaccharide (LPS) in 270 patients with different forms of meningococcal infection and in 816 healthy persons by means of the passive hemagglutination test are presented. The role of antibodies to LPS in the formation of humoral immunity to meningococci in sick children and adults is shown. Different forms of meningococcal infection have been found to have their specific features of the accumulation of antibodies to LPS. As revealed, the time of the sanation of liquor and the level of antibodies to LPS are unrelated, which indicates that antibodies to LPS may play some role in the pathogenesis of meningococcal infection.     

Epidemiological characteristics of meningococcal infection in Cuba

The results of the epidemiological analysis of the morbidity rate in meningococcal infection for 1976-1984 are presented. The maximum rise of morbidity rate, equal to 14.4 per 100000 of population, was observed in 1983. Primarily, the rise of morbidity rate in 1979 was induced by meningococci of two serogroups: C (44.6%) and B (36.4%). The vaccinal prophylaxis of the population, carried out in 1979 with the use of polysaccharide vaccine A + C, did not affect morbidity caused by group B meningococci. The isolation rate of these organisms reached 98.7% from patients and 81.0% from carriers. The characteristic feature of the epidemic process of meningococcal infection in Cuba was a considerable increase in the number of patients under 1 year of age and the absence of seasonal fluctuations in morbidity rate.     

The epidemiological characteristics of meningococcal infection in the USSR

The epidemiological analysis of morbidity in meningococcal infection in the USSR in the period of 1969-1987 showed that the second rise of the morbidity level occurred in 1984 and was followed by its decrease in most of the regions of the USSR. This study also revealed that the characteristic feature of the second rise of morbidity in meningococcal infection was a considerable involvement of young children (aged up to 3 years), as well as the increased etiological role of group B meningococci in cases of meningococcal infection and the circulation of these microorganisms among the population. Besides, the preservation of the etiological importance of group A meningococci in many regions of the USSR, especially among adults, was noted. In this connection, the use of Soviet group A meningococcal polysaccharide vaccine on epidemiological indications was considered to be epidemiologically substantiated.     

Criteria of the epidemiological surveillance of meningococcal infection

The results of studies carried out with the use of the unified, specially developed methods in eight regions of the USSR are generalized. Basing on the analysis of the results, the leading role of serogroup A meningococci in the rise of morbidity is emphasized, the relation of the morbidity level to the serogroup composition of meningococci circulating among healthy population is revealed, the necessity of carrying out selective bacteriological surveys with a view to establish the serogroups of meningococci circulating among the population is shown. The expedient criteria to be used in the system of epidemiological surveillance of meningococcal infection are presented.     

The role of fibronectin in the pathogenesis of meningococcal infection

We have characterized an interaction of 20 strains of Neisseria meningitidis serogroups A, B, C, 29E, W-135 and Z with immobilized fibronectin of human plasma. The adhesion of meningococci to fibronectin was determined by the extent of piliated cells and did not depend on the meningococcal serogroup. Binding of non-piliated or weakly piliated strains (2-5% of piliated cells in the stock) was sufficiently greater than those piliated (8-10%), where the adhesion to fibronectin was not at all observed. The examination of two well-piliated strains showed that the loss of pili resulted in the increase of bacterial adhesion to fibronectin. Constants of association and dissociation of piliated and non-piliated strains to fibronectin were calculated. The role of meningococci-fibronectin interaction in the pathogenesis of meningococcal infection is discussed.     

Model of meningococcal sepsis in mice]

The authors studied a possibility of obtaining experimental meningococcus sepsis model on mice. The use of cyclophosphane, iron compounds, yolk medium produced no significant organism. When 4--5% mucine was injected intraperitoneally together with meningococcus culture mice died with sepsis phenomena. Differences were revealed in the sensitivity of linear and mongrel mice to meningococcus infection--AKR mice proved to be more sensitive. At the same time it was found that mongrel mice weighing from 10 to 12 g could be used to induce meningococcus sepsis.     

Immunological factors in the evolution of the epidemic process in meningococcal infection

The results obtained in 1987 in the study of the immunostructure of the population of Yaroslavl with respect to meningococcal polysaccharides, groups, A, B, C, and lipopolysaccharide are presented in comparison with earlier results obtained in 1976. The regulating role of the immunological factor in the evolution of the epidemic process of meningococcal infection has been confirmed. The level of antibodies to meningococcal polysaccharides, groups A and B, has been found to reflect the intensity of the circulation of the infective agent among the population. The comparison of the results of investigations carried out in 1976 and 1987 has revealed the essential role of the lipopolysaccharide antigen in the formation of the postinfection immunity of the population to meningococcal infection, irrespective of the group of the infective agent.     

Results of a controlled epidemiological trial of the application of placental gamma globulin in foci of meningococcal infection]

Controlled epidemiological trial was applied to the study of the use of placental gamma-globulin for prophylaxis of generalized forms of meningococcus infection in the foci (creches and kindergartens). A group of the vaccinated children (16 140) and control group (16 080) were the same age and sex. Gamma-globulin was administered in a dose of 3 ml to every other child attending creches and kindergartens not later than the 10th day after the patient's isolation. It was shown that the efficacy coefficient of gamma-globulin in the foci of meningococcus infection constituted 68% (the efficacy index was 3.2) for one month after the administration.     

Characteristics of the meningococcal carrier state in organized collectives and its role in the development of generalized forms of meningococcal infection

Complex (epidemiological and bacteriological) investigations of the level and structure of meningococcal carriership among the members of organized collective bodies differing in the epidemiological situation with respect to meningococcal infection have been carried out. The absence of differences between the total level of meningococcal carriership and the morbidity rate with respect to the generalized forms of meningococcal infection has been shown. The presence of cases of meningococcal meningitis in the groups under study has been found to depend on the intensity of the circulation of certain meningococcal serogroups. The possibility of the ecological reservation of the causative agents of meningococcal infection as polyagglutinable forms has been suggested.     

The phenomenon of HLA antigen modification in meningococcal infection

212 patients with the generalized forms of meningococcal infection have been examined. The intensity and quality of lymphocytotoxic reaction in the acute phase and the convalescence period of the disease have been analyzed and the blank calculation has been made at different clinical forms of meningococcal infection. The formation of modified tissue antigens at the acute stage of the disease in the presence of intoxication is shown and the probable role of the intensity of bacteremia in this formation is discussed.     

Epidemiologic analysis morbidity with meningococcal infections in the USSR]

The authors present the analysis of the incidence of epidemic cerebrospinal meningitis in the USSR from 1937 to 1974, and of meningococcus infection from 1965 to 1974. A rise of the meningococcus infection incidence from 1969 to 1974 was recorded 28 years after the elevation of 1940-1942 and was 1.5 times below this latter rise. The rise in 1969-1974 was characterized by marked signs peculiar to the infection with the droplet transmission mechanism; among those who contracted the disease prevalence was seen among children aged under 14 years (63-72%). A marked affection of juveniles was noted. Three types of the dynamic of the meningococcus infection incidence in the republics located in different climatic-geographical zones of the USSR were noted: slow, gradual increase of the level, interrupted and explosive. Such character was determined in the dynamics of the seasonal elevations of morbidity. Antiepidemic measures including a complex of nonspecific measures could not be assessed as sufficiently effective. This finds reflection in the natural course of the epidemic process of the meningococcus infection which remains uncontrolled. From the patients with generalized form of the disease meningococci of group A were isolated in 80-100% of cases, from the number of those typed. The group-specific reference of the nasopharyngeal strains depended on the epidemic situation: strains of serological group A prevailed at the period of the morbidity elevation, and other serological groups (particularly of C and B) increased at its decline.     

Characterization of the foci of meningococcal infection in closed groups of males

A total of 257 foci of meningococcal infection in groups of servicemen were selectively examined in 1982-2002. From these groups 353 patients with generalized forms of the disease underwent hospitalization. Most of the foci had a single infection, the proportion of foci with 10-40 patients was 82.6%. The meningococcal infection rate among humans in the foci was 25-37%, group A meningococci playing the leading role. In the structure of meningococcal infection generalized forms of infection constituted 16%, localized forms constituted 25% and inapparent forms (carriers)--59%. The formation of the morbidity structure was influenced by the type of the focus (with a single or multiple infection) and the character of morbidity for many years (during epidemic or at the period between epidemics). No absolute dependence of the level of meningococcal carrier state in the groups of servicemen on the appearance of the generalized forms of meningococcal infection was noted. Thus, both during epidemic and at the period between epidemics the population of meningococci, heterogeneous in its serological structure and differing in its clinical and epidemiological importance, constantly circulated with the leading role played by group A meningococci.     

Evaluation of the immunogenicity of meningococcal vaccines in experiments on mice]

The immunogenicity of 2 meningococcal vaccines, multicomponent vaccine produced at the Mechnikov Research Institute for Vaccines and Sera in Moscow and polysaccharide vaccine obtained from Merck Sharp & Dohme (USA), was evaluated on experimental meningococcal sepsis in mice, produced by the injection of meningococcal culture in mucin suspension. The protective effect of these 2 vaccines, expressed in terms of ED50, was 0.28 +/- 0.12 for the multicomponent vaccine and 0.25 +/- 0.24 for the polysaccharide vaccine; the challenge dose used in the test was 10 LD50 of the culture. The multicomponent vaccine gave the maximum immunological effect in a dose of 8 micrograms, while higher or lower doses induced a lesser increase in antibody titer and thus gave lower protection to mice against infection.