https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(07)61016-2.pdf

Epidemic meningitis, meningococcaemia, and Neisseria meningitidis.

Considerations for formulating the second-generation pneumococcal capsular polysaccharide vaccine with emphasis on the cross-reactive types within groups.

Neisseria meningitidis serogroups B and C were originally subdivided into serotypes by the use of two different classification systems based upon type-specific bactericidal antibodies and immunoprecipitation in agar gels, respectively. The serotype specificities were later found to be associated with different major outer membrane proteins and with the lipopolysaccharide. Physiochemical characterization of the four to five major outer membrane proteins has resulted in designation of classes 1-5 on the basis of peptide mapping. The class 2 (41,000-dalton) or class 3 (38,000-dalton) protein is present in all meningococcal strains. They both are predominant proteins, show a useful degree of antigenic variation, and are epidemiologically relevant. A new serotyping nomenclature and scheme based on these two proteins and the lipopolysaccharide is therefore proposed. With use of this scheme, a meningococcal strain could be identified by serogroup to protein-serotype to lipopolysaccharide serotype, as in B:2a:L3. The class 1 (46,000-dalton) protein can be used to further define a meningococcal strain, as in B:2a:P1.2:L3.

Serotype antigens of Neisseria meningitidis and a proposed scheme for designation of serotypes.

Immunologic Response of Man to Group B Meningococcal Polysaccharide Vaccines

In spite of considerable success in the development of drugs and vaccines, the problem of disease due to Neisseria meningitidis is far from solved. As late as the 1970s, epidemics of meningococcal disease occurred in at least 30 countries in all parts of the world. Most of the epidemics were caused by group A organisms, but epidemics due to groups B and C also took place occasionally. The case/fatality rate was usually less than 10% among patients with true meningitis; among those with "pure" septicemia, it was as high as 70%. Children less than five years old are most prone to meningococcal disease, but mortality is often highest among young adults. Because close contacts of the index case are at considerable risk--at least several hundred times higher than in the rest of the population--they should be protected immediately with an appropriate antibiotic and, if possible, with a vaccine as well. At the present time, however, no vaccine is available for use against group B organisms, which in nonepidemic conditions are the most prevalent of all meningococci.

Meningococcal Disease: Still with Us

Group C meningococcal polysaccharide vaccine was administered to 13,763 Army recruit volunteers at five basic training centers. These men represented 20 per cent of 68,072 recruits under o...

https://www.nejm.org/doi/pdf/10.1056/NEJM197002192820803?listPDF=true

Prevention of Meningococcal Disease by Group C Polysaccharide Vaccine

A second large-scale field trial of group C meningococcal polysaccharide vaccine in US Army recruits confirmed the efficacy and safety of the vaccine. When the results of all studies over a 2-year period were combined, the reduction in group-specific disease rates was 89.5%.

Meningococcal infections: 2. Field trial of group C meningococcal polysaccharide vaccine in 1969-70

A bactericidal assay is described which allows identification of distinct serotypes within a serogroup of Neisseria meningitidis. Antisera produced in rabbits against seven group C strains by two intravenous inoculations of live organisms were found to contain two types of bactericidal antibodies. One, directed against the group-specific polysaccharide, caused various degrees of killing of all strains. Absorption of this antibody by purified group C polysaccharide revealed the presence of the second bactericidal antibody. This antibody was directed against antigenically distinct factors associated with serotype specificity. Extensive cross-absorption yielded antisera with activity directed against four separate factors. The presence of a factor in a strain was indicated by its susceptibility to killing by antisera containing antibody to that factor. A serotype was defined by the particular combination of factors. Six different serotypes, containing one or two factors, were identified among 16 group C strains examined.

https://iai.asm.org/content/iai/1/5/479.full.pdf

New Classification of Neisseria meningitidis by Means of Bactericidal Reactions

One hundred forty-three strains isolated from cases of diseases due to Group C meningococci in Army recruits and in civilians between 1964 and 1970 have been serotyped by means of a bactericidal assay. Six serotypes were identified. The predominance of serotype 2 strains during epidemics at Fort Dix, New Jersey (42 of 47 strains) and Fort Lewis, Washington (15 of 23 strains) and the increasing prevalence of serotype 2 in cases both at other recruit training centers and among civilians, strongly suggest the existence of an epidemic strain of Group C meningococcus. Ninety-four percent of serotype 2 strains were reistant to sulfadiazine; in contrast, only 996 of serotype 1 and 5296 of serotype 4 were resistant. The serotype and the degree of susceptibility of sulfadiazine serve as two markers identifying an epidemic strain of Neisseria meningitidis.

Identification of an Epidemic Strain of Group C Neisseria meningitidis by Bactericidal Serotyping

In a recent report, the isolation and characterization of meningococcal polysaccharides of serogroups A, B, and C have been described [1]. Immunization of human volunteers with the purified polysaccharide of groups A and C meningococci resulted in the development of antibodies as measured by hemagglutination (HA) , bactericidal assay, and fluorescent antibody techniques [2, 3]. In these studies a dose of 50 ig was administered intracutaneously. Local skin reactions occurred in all recipients of vaccine, but these were minimal and disappeared within 48 hr. No systemic reactions were observed. The current studies were undertaken with the

Ronald Gold

Papers

Prevention of Meningococcal Disease by Group C Polysaccharide Vaccine

Meningococcal infections: 2. Field trial of group C meningococcal polysaccharide vaccine in 1969-70

New Classification of Neisseria meningitidis by Means of Bactericidal Reactions

Identification of an Epidemic Strain of Group C Neisseria meningitidis by Bactericidal Serotyping

Cutaneous reactions and antibody response to meningococcal group C polysaccharide vaccines in man.