Meningococcal vaccines and vaccine developments.

Despite rapid advances in the diagnosis of bacterial infections and the availability of effective antibiotics, meningococcal disease continues to represent a substantial public health problem for most countries (1-4). Disease usually develops rapidly, is notoriously difficult to distinguish from other febrile illnesses, and generally has a high case-fatality rate. The death of an otherwise fit and healthy individual can occur within a very short time from the first appearance of symptoms, those who survive frequently suffer from permanent tissue damage and neurological problems (4,5). Consequently, the development and implementation of effective immunoprophylaxis is a sine qua non for the comprehensive control of meningococcal disease. From an historical perspective, many meningococcal vaccines have been developed and evaluated in clinical trials; unfortunately, no vaccine so far offers comprehensive protection. This overview traces the development of the existing licensed vaccines and examines the prospects of vaccine candidates that are currently under development or subject to clinical evaluation.