Cuban vaccine against meningitis?

Mark Achtman Achtman at MPIMG-Berlin-Dahlem.MPG.DE
Sun Apr 9 18:18:28 EST 1995

Zorro <berriz at husc.harvard.edu> wrote:

>chatski at umbc.edu (chatski carl) writes in sci.bio.microbiology:

>>The Cubans developed a vaccine for meningitis type-B sometime prior to
>>1991.  They donated many doses to African countries and traded
>>3-million doses to Brazil, in June of 1991, in return for soybeans,
>>other food products, and spare parts.

>>Over United States objections, the vaccine has been approved by
>>international bodies.  The US refused to use the vaccine ( on
>>political grounds ) during a meningitis outbreak during which some
>>children died.
The vaccine is still considered experimental because despite the
original Cuban data, which indicated very high efficiency, subsequent
useage has shown that the Cuban vaccine is not that effective in very
young children. The primary interest in licensing the vaccine in the
US would be for the very young children that are not as well
protected. However, there has been a recent rise in group B
meningococcal disease in Oregon, caused by bacteria related to those
against which the Cuban vaccine was generated, and possibly the Cuban
vaccine will be considered for use in the future in the US.

>My repeated efforts to find references in the scientific literature to
>this vaccine have come up dry. 
This sounds like you might not be familiar with the literature on the
pathogenic Neisseriae. Several key references are the following:

Sierra G., V.G., Campa H., C., Garcia I., L., Sotolongo P., F.,
Izquierdo P., L., Valcarcel N., M., Casanueva G., V., Baro S., M.,
Leguen C., F., Rodriguez C., R., and Terry M., H. Efficacy evaluation
of the Cuban vaccine VA-MENGOC-BC against disease caused by serogroup
B Neisseria meningitidis. In: Neisseriae 1990, edited by Achtman, M.,
Kohl, P., Marchal, C., Morelli, G., Seiler, A., and Thiesen,
B.Berlin:Walter de Gruyter, 1991,p. 129-134

This book contains short articles summarizing talks and posters held
at the 1990 pathogenic Neisseriae meeting in Berlin, Germany

Milagres, L.G., Ramos, S.R., Sacchi, C.T., Melles, C.E.A.,
Brandileone, M.C.C., Vieira, V.S.D., Sato, H., Brito, G.S., Moraes,
J.C., and Frasch, C.E. Immune response of Brazilian children to a
serogroup B meningococcal outer membrane protein vaccine. In:
Pathobiology and Immunobiology of Neisseriaceae, edited by Conde-Glez,
C.J., Morse, S., Rice, P., Sparling, F., and Calderón,
E.Cuernavaca:Instituto Nacional de Salud Pública, 1994,p. 874-879

This book contains short articles summarizing talks and posters held
at the 1992 pathogenic Neisseriae meeting in Cuernavac, Mexico
Talks and posters held at the 1994 meeting in Winchester,  UK will not
be published. The 1996 meeting will be held in Washington, DC
Additional single articles in my collection are:
.De Moraes, J.C., Perkins, B.A., Camargo, M.C.C., Hidalgo, N.T.R.,
Barbosa, H.A., Sacchi, C.T., Gral, I.M.L., Gattas, V.L., De
G.Vasconcelos, H., Plikaytis, B.D., Wenger, J.D., and Broome, C.V.
Protective efficacy of a serogroup B meningococcal vaccine in Sao
Paulo, Brazil. Lancet 340:1074-1078, 1992.

Milagres, L.G., Ramos, S.R., Sacchi, C.T., Melles, C.E.A., Vieira,
V.S.D., Sato, H., Brito, G.S., Moraes, J.C., and Frasch, C.E. Immune
response of Brazilian children to a Neisseria meningitidis serogroup B
outer membrane protein vaccine:  Comparison with efficacy.
Infect.Immun. 62:4419-4424, 1994. 
A good reference on the Norwegian vaccine is
Boevre, K., Bjune, G., Caugant, D.A., Froeholm, L.O., Hoeiby, E.A.,
Rosenqvist, E., and Wedege, E. Meningococcal serogroup B vaccine
protection trial in Norwegian teenagers October 1988 -May 1991. NIPH
Ann 14:46-250, 1991. 
whereas the following is a brief description
Bjune, G., Hoeiby, E.A., Groennesby, J.K., Arnesen, O., Fredriksen,
J.H., Halstensen, A., Holten, E., Lindbak, A.-K., Nokleby, H.,
Rosenqvist, E., Solberg, L.K., Closs, O., Eng, J., Froholm, L.O.,
Lystad, A., Bakketeig, L.S., and Hareide, B. Effect of outer membrane
vesicle vaccine against group B meningococcal disease in Norway.
Lancet 338:1093-1096, 1991. 
The Oregon situation is described in
the last issue in February of the MMWR (I'm at home and don't have the
citation handy here), which is also available as a WWW server. A
general citation on epidemic meningitis is 
Moore, P.S. and Broome, C.V. Cerebrospinal meningitis epidemics.
Sci.Am. 271:38-47, 1994.
whereas possibly the best current description of meningococcal
meningitis is
Cartwright, K. Meningococcal disease, Chichester, England:John Wiley &
Sons, Ltd, 1995. 
>I don't know if my difficulties finding information on this vaccine
>result from a specific blocking of these particular news (i.e. the
>vaccine and related issues), or from the general scarcity in the US of
>news from Cuba. 
Given that the MMWR is a CDC journal and part of the discussion in
that article consists of a description of the Cuban and Norwegian
vaccines (with citations), it doesn't sound like there's anything
political going on. It does sound like you haven't been using the
right tools for citation searching. However, to be fair most research
on meningococcal meningitis is currently being performed in Europe
because meningococcal meningitis has not been a major epidemiological
problem in the US since the 2nd world war.

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