Caister Academic Press

Epidemiology in the Vaccine Era

Caroline Trotter, Gwenda Hughes and Cathy Ison
from: Neisseria: Molecular Mechanisms of Pathogenesis (Edited by: Caroline Genco and Lee Wetzler). Caister Academic Press, U.K. (2010)

Abstract

The pathogenic species of the genus Neisseria, Neisseria meningitidis and Neisseria gonorrhoeae share much of their genome, but differ markedly in many other respects. N. meningitidis colonises the mucosal surfaces primarily of the upper respiratory tract as part of the normal flora and occasionally invades to cause systemic disease with subsequent serious sequelae, morbidity and mortality, compared to N. gonorrhoeae which mainly colonises the mucosa of the anogenital tract, rarely invades to cause serious systemic disease but is always considered a pathogen. N. meningitidis and N. gonorrhoeae are inherently susceptible to antimicrobial agents but N. gonorrhoeae has been particularly adept at acquiring or developing resistance to many therapeutic agents, which has not been such a major problem in N. meningitidis. Many of the major antigens are shared between these two species with the exception of the polysaccharide capsule found on the meningococcus, which can elicit a protective immune response. There is a lack of an apparent protective immune response to N. gonorrhoeae, with multiple episodes occurring in a single individual which results from the extra-ordinary ability of the organism for antigenic variation, in addition to the absence of the capsule. This chapter addresses the epidemiology of both of these neisserial infections and consequently allows the comparison of an infection with the potential to be controlled by vaccination with a second which is largely controlled by antimicrobial therapy alone. This is all the more interesting given that genetically these organisms are so closely related and came from the same progenitor
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