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      Impfprophylaxe rekurrierender invasiver Erkrankungen mit Meningokokken : Stellungnahme der Kommission für Infektionskrankheiten und Impffragen vom 31. März 2022 Translated title: Vaccination prophylaxis for recurrent invasive meningococcal diseases : Statement of the Committee for Infectious Diseases and Vaccinations from 31 March 2022

      review-article
      , Kommission für Infektionskrankheiten und Impffragen der Deutschen Akademie für Kinder- und Jugendmedizin e. V. (DAKJ)
      Monatsschrift Kinderheilkunde
      Springer Medizin
      Impfung, Meningokokken Serogruppe A, B, C, W, Y, Impfschutz, Invasive Meningokokken-Erkrankung, Rekurrierende invasive Meningokokkeninfektion, Vaccination, Meningococci group A, B, C, W, Y, Immunization protection, Invasive meningococcal disease, Recurrent invasive meningococcal infection

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          Abstract

          Meningokokkenerkrankungen sind selten, führen jedoch zu einer hohen Morbidität und Mortalität. Das Risiko, sich erneut mit einem anderen oder dem gleichen Serotyp zu infizieren, ist nach durchgemachter Infektion und bei bestimmten Vorerkrankungen wie Komplementdefekten deutlich erhöht.

          Die Kommission hält folgendes Vorgehen für sinnvoll:

          Kinder und Jugendliche ohne vollständigen Meningokokkenimpfstatus sollten unmittelbar nach Ausheilung einer invasiven Meningokokkenerkrankung eine Impfung mit 4CMenB (Bexero®, Trumenba®) und/oder eine Impfung gegen die Serogruppen A, C, W und Y (Menveo®, Nimenrix®, MenQuadfi®) nach Vorgabe der Fachinformationen erhalten. Ein vorheriges isoliertes Screening auf Komplementdefekte ist für die Impfentscheidung bei diesen Patienten nicht erforderlich.

          Translated abstract

          Invasive meningococcal diseases are rare but lead to a high morbidity and mortality in the patients. The risk of becoming infected again with a different or the same serotype is significantly increased after an infection has gone through and in the case of certain previous illnesses such as complement defects.

          The Committee for Infectious Diseases and Vaccinations of the German Academy for Pediatrics and Adolescent Health proposes the following approach for prevention of recurrent invasive meningococcal infections:

          Children and adolescents without a complete meningococcal vaccination status should be vaccinated with 4CMenB (Bexero®, Trumenba®) and/or vaccinated against serogroups A, C, W and Y (Menveo®, Nimenrix®, MenQuadfi®) immediately after healing of an invasive meningococcal disease according to the specification of the information for healthcare professionals. Prior isolated screening for complement deficiencies is not necessary for the vaccination decision in these patients.

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          Most cited references5

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          Infectious diseases associated with complement deficiencies.

          The complement system consists of both plasma and membrane proteins. The former influence the inflammatory response, immune modulation, and host defense. The latter are complement receptors, which mediate the cellular effects of complement activation, and regulatory proteins, which protect host cells from complement-mediated injury. Complement activation occurs via either the classical or the alternative pathway, which converge at the level of C3 and share a sequence of terminal components. Four aspects of the complement cascade are critical to its function and regulation: (i) activation of the classical pathway, (ii) activation of the alternative pathway, (iii) C3 convertase formation and C3 deposition, and (iv) membrane attack complex assembly and insertion. In general, mechanisms evolved by pathogenic microbes to resist the effects of complement are targeted to these four steps. Because individual complement proteins subserve unique functional activities and are activated in a sequential manner, complement deficiency states are associated with predictable defects in complement-dependent functions. These deficiency states can be grouped by which of the above four mechanisms they disrupt. They are distinguished by unique epidemiologic, clinical, and microbiologic features and are most prevalent in patients with certain rheumatologic and infectious diseases. Ethnic background and the incidence of infection are important cofactors determining this prevalence. Although complement undoubtedly plays a role in host defense against many microbial pathogens, it appears most important in protection against encapsulated bacteria, especially Neisseria meningitidis but also Streptococcus pneumoniae, Haemophilus influenzae, and, to a lesser extent, Neisseria gonorrhoeae. The availability of effective polysaccharide vaccines and antibiotics provides an immunologic and chemotherapeutic rationale for preventing and treating infection in patients with these deficiencies.
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            Infektionsepidemiologisches Jahrbuch meldepflichtiger Krankheiten für 2019

            (2020)
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              Waldenström's disease complicated by recurrent meningococcal arthritis.

              Meningococcal arthritis is rare. We report a patient in whom a first episode of meningococcal arthritis revealed Waldenström's disease and who experienced a second episode of meningococcal arthritis 8 years later. We suggest that an impaired immune response secondary to Waldenström's disease favored the recurrence of meningococcal arthritis.
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                Author and article information

                Contributors
                kontakt@dakj.de
                Journal
                Monatsschr Kinderheilkd
                Monatsschr Kinderheilkd
                Monatsschrift Kinderheilkunde
                Springer Medizin (Heidelberg )
                0026-9298
                1433-0474
                1 July 2022
                2022
                : 170
                : 8
                : 738-742
                Affiliations
                GRID grid.500070.2, Kommission für Infektionskrankheiten und Impffragen, , Deutsche Akademie für Kinder- und Jugendmedizin e. V. (DAKJ), ; Chausseestr. 128/129, 10115 Berlin, Deutschland
                Author notes
                [Redaktion]

                A. Borkhardt, Düsseldorf

                S. Wirth, Wuppertal

                Article
                1510
                10.1007/s00112-022-01510-y
                9309446
                8c71753a-3c3a-4303-8086-0fa8be783de6
                © The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2022

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 22 April 2022
                Categories
                Konsensuspapiere
                Custom metadata
                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2022

                impfung,meningokokken serogruppe a, b, c, w, y,impfschutz,invasive meningokokken-erkrankung,rekurrierende invasive meningokokkeninfektion,vaccination,meningococci group a, b, c, w, y,immunization protection,invasive meningococcal disease,recurrent invasive meningococcal infection

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