Greenwood B
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine.
Trans R Soc Trop Med Hyg. 1999 Jul-Aug;93(4):341-53. doi: 10.1016/s0035-9203(99)90106-2.
This review covers the history of meningococcal meningitis in Africa since epidemics of the infection were first described around 100 years ago. It is possible that an epidemic strain of the meningococcus was introduced into West Africa from the Sudan by pilgrims returning from the Haj around the turn of the century. Since 1905 major epidemics of meningococcal meningitis have occurred in countries of the Sahel and sub-Sahel every few years, culminating in a massive epidemic in which nearly 200,000 cases were reported in 1996. Attempts to control epidemic meningococcal meningitis in Africa by vaccination with meningococcal polysaccharide vaccines have met with only modest success because epidemics can progress with great rapidity and vaccination is often started too late. This situation should be improved as a result of a recent initiative, the International Coordinating Group (ICG), which is contributing to better surveillance in countries at risk and ensuring that vaccine is available when needed. However, in the medium term, the best prospect for the control of meningococcal meningitis in Africa lies in the recent development of polysaccharide-protein conjugate vaccines which, unlike polysaccharide vaccines, are immunogenic in the very young, induce immunological memory and are likely to give long-lasting protection.
本综述涵盖了自约100年前首次描述该感染的流行情况以来，非洲脑膜炎球菌性脑膜炎的历史。在世纪之交，朝圣者从麦加朝觐返回时，可能将一种脑膜炎球菌流行菌株从苏丹引入了西非。自1905年以来，萨赫勒和次萨赫勒地区的国家每隔几年就会发生一次脑膜炎球菌性脑膜炎的大流行，1996年达到顶峰，报告了近20万例病例。通过接种脑膜炎球菌多糖疫苗来控制非洲流行性脑膜炎球菌性脑膜炎的尝试仅取得了一定程度的成功，因为疫情发展迅速，而疫苗接种往往开始得太晚。由于最近的一项举措——国际协调小组（ICG），这种情况应该会得到改善，该小组正在促进对高危国家进行更好的监测，并确保在需要时提供疫苗。然而，从中期来看，控制非洲脑膜炎球菌性脑膜炎的最佳前景在于最近开发的多糖-蛋白质结合疫苗，与多糖疫苗不同，这种疫苗在幼儿中具有免疫原性，能诱导免疫记忆，并且可能提供长期保护。
