Preventing Meningococcal Disease: Defining Risk and Differentiating Serogroups

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Program Overview:

Few would argue that meningococcal disease represents one of the more challenging bacterial infections encountered by healthcare professionals. This disease is caused by the gram-negative diplococcus bacterium Neisseria meningitidis, which colonizes humans exclusively and is estimated to be carried, primarily in the nasopharynx, by 5% to 10% of the general population. The infection is highly contagious and is transferred from person to person in droplets of respiratory or throat secretions. Up to 2800 cases of invasive meningococcal disease occur each year in the U.S., with the most vulnerable age groups being infants less than 1 year old (16% of cases) and adolescents ages 14 through 24 (20% of cases). The seriousness of this disease derives from its high fatality rate (10-14%) and the high rate of disability, including limb loss, neurologic deficit and deafness (11-19%) associated with survivors. Importantly, meningococcal disease is not caused by a single-strain pathogen, but by 13 serogroups, of which 5 (MenABCYW-135) cause the vast majority (95%) of meningococcal disease worldwide.

Several factors have made it difficult for primary care clinicians to keep abreast of optimal preventive strategies addressing the threat of meningococcal disease. One is the fact that it is caused by multiple serotypes of meningococcus. Another is lack of understanding, and/or under appreciation of the benefit/risk of vaccination in specific patient subgroups, particularly pre-adolescents. Other factors include the development of newer vaccines, numerous studies of their efficacy and safety, as well as rapidly evolving recommendations of the Centers for Disease Control (CDC) and the Advisory Committee on Immunization Practices (ACIP). This program will provide the clinician with knowledge of the most current guidelines of the CDC and ACIP, and understanding of the factors affecting the choice of vaccine and follow up needed. It will also provide clinicians specific resources for maintaining currency in this area, as well as tools for increasing their patients’ awareness of, and access to, vaccination against the broadest range of meningococcal serotypes.

Learning Objectives

After completing this activity, the participant will be able to:

• Identify patient groups at high risk for meningococcal infection and employ effective screening procedures and routine review of immunization records to ensure appropriate vaccination rates
• Understand the correspondence between the strains or serogroups of N meningitides prevalent in the U.S. and the characteristics such as vaccine class (polysaccharide, conjugate), specificity for one or more strains, efficacy, and safety of the currently approved vaccines

Accreditation/Designation Statement

Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Primary Care Network designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Target Audience:
This activity is targeted to all physicians and other healthcare professionals who treat patients with meningococcal disease.

Release Date: February 23, 2009
Expiration Date: February 23, 2010

Medium: Podcast

Acknowledgement of Commercial Support:

This activity was developed from the live Best Practices in Pediatrics™ program held in Hollywood, California on November 15, 2008, which was funded by Novartis Vaccines and Diagnostics.

Method of Participation:

To receive CME credit for this activity, you need to listen to the program. Upon finishing the podcast, complete the post-test and evaluation and fill out all required personal information. To receive your CME certificate you will need to pass the post-test with 70% accuracy or better.

Post-test and Evaluation:

After completing this activity, click on the Post-test button at the end of the program. If you receive less than 70% on the post-test, you will be returned to the beginning of the activity to review the presentation again. Upon successful completion of the post-test, you will be asked to fill out a program evaluation form and prompted to print your CME certificate.

Statement of Disclosure and Independence:

It is the policy of Primary Care Network, Inc. to ensure all its sponsored educational activities are planned, developed, and conducted in accordance with the ACCME’s Essential Areas and Policies. In accordance with ACCME requirements, Primary Care Network has Conflict of Interest and Disclosure Policies that are designed to ensure that Primary Care Network sponsored educational activities are fair balanced, independent, evidence-based and based on scientific rigor.

Primary Care Network’s Resolution of Personal Conflicts of Interest (COI) Policy aims to ensure that all conflicts are resolved prior to the activity, content is developed and presented free of commercial bias, and is in the interest of promoting improvements or quality in healthcare. All individuals who are in a position to influence and/or control content of a Primary Care Network sponsored activity are required to disclose to the participants any real or apparent conflict of interest related to the activity. The educational content is also reviewed for independence and content validation by an independent external clinical reviewer and internal clinical reviewer. Independence is also monitored through the activity and overall program evaluation process.

The opinions, ideas, recommendations, and perspectives expressed in the accompanying presentations at this Primary Care Education program are those of the program authors and presenting faculty only and do not necessarily reflect the opinions, ideas, recommendations or perspectives of their affiliated institutions, Primary Care Network, Primary Care Education, Advisory Boards and Consultants, or the activity’s commercial supporters.

Planning Committee and Disclosures
The National Leadership Council on Vaccine Education planning committee includes:

Philip L. Barkley, MD
Director and Associate Professor
Student Health Care Center
University of Florida
Alachua, FL

Dr. Barkley is a member of the speaker’s bureau for Merck & Co., Inc. and Sanofi Pasteur.

Robert B. Belshe, MD
Professor of Medicine, Pediatrics, and Molecular Microbiology
Director, Division of Infectious Diseases and Immunology
St. Louis University School of Medicine
St. Louis, MO

Dr. Belshe is a member of the speaker’s bureau for MedImmune, Inc., Merck & Co., Inc., Novartis Pharmaceuticals, and sanofi-aventis. He is also a consultant to and serves on the advisory boards for MedImmune, Merck, and Novartis.

Daniel N. Duch, PhD
Medical Director
The Chatham Institute
Chatham, NJ

Dr. Duch has nothing to disclose.

Christine M. Grant, JD, MBA
CEO
InfecDetect
Princeton, NJ

Ms. Grant is a stockholder of Abbott Laboratories, Baxter, Genentech, Inc., Hoffman-La Roche Ltd., Johnson & Johnson, Novartis Pharmaceuticals, Novo Nordisk, sanofi-aventis, and Wyeth Pharmaceuticals.

Lee H. Harrison, MD
Professor and Head
Infectious Diseases Epidemiology Research Unit
University of Pittsburgh
Pittsburgh, PA

Dr. Harrison is a member of the speaker’s bureau for Sanofi Pasteur and Wyeth Pharmaceuticals. He serves on the advisory boards for Novartis Pharmaceuticals and Sanofi Pasteur and is a consultant to GlaxoSmithKline, Merck & Co., Inc., and Sanofi Pasteur. He also receives grant support from Sanofi Pasteur.

James W. Howatt, MD, MBA
Chief Medical Officer
Molina Healthcare
Long Beach, CA

Dr. Howatt serves on the advisory board for Teva Pharmaceuticals Industries, Ltd.

Jeff D. Januska, PharmD
Director of Pharmacy
Santa Barbara Regional Health Authority
Ventura, CA

Mr. Januska serves on the advisory boards for Abbott Laboratories, Forest Laboratories, Inc., GlaxoSmithKline, and Takeda Pharmaceuticals North America, Inc.

Michael A. Kaufman, MD, JD
Senior Medical Director
United Health Group
Newport Coast, CA

Dr. Kaufman has nothing to disclose.

Catherine O'Keefe, DNP, APRN
Associate Professor/Pediatric Nurse Practitioner
Division of Pediatric Infectious Diseases
Creighton University Medical Center
Omaha, NE

Ms. Catherine O’Keefe has received grant support from GlaxoSmithKline, Merck & Co., Inc., Novartis Pharmaceuticals, sanofi-aventis, and Wyeth Pharmaceuticals.

Steven R. Peskin, MD, MBA
Chief Medical Officer
The Chatham Institute
Chatham, NJ

Dr. Peskin has nothing to disclose.

Richard A. Reinking, MD
Warren Clinic
St. Francis Health System
Tulsa, OK

Dr. Reinking has nothing to disclose.

Sandra F. Ryan, RN, MSN, CPNP
Chief Nurse Practitioner Officer
Take Care Health Systems, LLC
Medford, NJ

Ms. Ryan has nothing to disclose.

Deborah L. Wexler, MD
Founder and Executive Director
Immunization Action Coalition
St. Paul, MN

Dr. Wexler has nothing to disclose.

Neil L. Youngerman, MD
Pediatrician Somerset Pediatric Group
Hillsborough, NJ

Dr. Youngerman has nothing to disclose.

Faculty and Disclosures

Lawrence A. Ross, MD
Professor of Pediatrics, Children’s Hospital Los Angeles
Keck School of Medicine
University of Southern California
Los Angeles, CA

Dr. Ross is a member of the speaker’s bureau for Merck & Co., Inc. and Pfizer Inc., and is a consultant for Merck & Co., Inc.

Richard G. Judelsohn, MD
Managing Partner, Buffalo Pediatric Associates
Medical Director, Erie County Health Department
Buffalo, NY

Dr. Judelsohn is a member of the speaker’s bureau for GlaxoSmithKline, MedImmune, Inc., Merck & Co., Inc., and sanofi-aventis and serves on the advisory board for GlaxoSmithKline, MedImmune, Inc., and Merck & Co., Inc. He is also a consultant for GlaxoSmithKline and MedImmune, Inc.

Stanford T. Shulman, MD
Virginia H. Rogers Professor of Pediatric Infectious Diseases
Northwestern University
The Feinberg School of Medicine
Chief, Division of Infectious Diseases
The Children’s Memorial Hospital
Chicago, IL

Dr. Shulman is a member of the speaker’s bureau for GlaxoSmithKline and Merck and he serves on the advisory board of Novartis.

Review Committee Disclosure

In accordance with our policy, all content is reviewed by external independent peer reviewers for balance, objectivity and commercial bias. The peer reviewers, staff, and other individuals who control content have no relevant financial relationships to disclose.

Unlabeled Use Declaration:

During their presentation(s), faculty may discuss an unlabeled use or an investigational use not approved for a commercial product. Each faculty member is required to disclose this information to the audience when referring to an unlabeled or investigational use.

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