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8. Reducing the impact of group C meningococcal infection in young people

Press headlines concerning meningitis

Government efforts to reduce the impact of most common and potentially deadly causes of meningitis and septicaemia have focused on a number of fronts including vaccine development, public awareness campaigns and careful surveillance of the incidence of the illness.

When Sir Liam Donaldson took up the post of Chief Medical Officer in 1998 meningococcal meningitis was the commonest form of bacterial meningitis, and the incidence of serogroup C infection was increasing sharply. More children and young people were falling ill and dying with the disease than usual, and outbreaks in villages, schools and universities were causing great concern.

Meningococcal disease, and in particular septicaemia, was also the commonest infectious cause of death in children and young people up to 20 years.  Approximately 40% of cases of meningococcal disease (both meningitis and septicaemia) were caused by group C organisms.

The development of the meningitis C vaccination in the UK

In the years 1998/9 there were about 1,500 cases of meningococcal disease and around 150 people died. Newspaper headlines reflected the fear and anxiety of millions of parents around the country. A vaccine to combat the group C form of meningococcal disease was already under development, and health ministers decided the vaccine should be made available as soon as possible.

Vaccine trials had been conducted in the UK since 1994, evaluating the safety and efficacy of the meningococcal C conjugate vaccines. The trials were based on the success of the Hib conjugate vaccine, introduced in 1992, and knowledge of the changing spread of group C meningococcal disease in other countries.

The UK took a leading role in the development of the new meningococcal C conjugate vaccine (MenC) and the Department of Health sponsored an intensive 5-year vaccine trial research programme which underpinned the introduction of the vaccine. The programme involved collaboration between government, industry, and health protection agencies.

This unique collaboration made it possible to compare the performance of different manufacturers’ products, and  provided answers to policy questions that were specific to the UK.  As a result, many issues had already been addressed before meningococcal C vaccines were licensed in this country and so it was possible to introduce the vaccine without delay.

Since its introduction in the UK in 1999, a number of other countries including the Netherlands, Belgium, Ireland, Canada, France, Spain and Australia have introduced the vaccine either on a routine basis or in selected areas.

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