• Reinaldo Acevedo, Xilian Bai, Ray Borrow, Dominique A Caugant, Josefina Carlos, Mehmet Ceyhan, Hannah Christensen, Yanet Climent, Philippe De Wals, Ener Cagri Dinleyici, Gabriela Echaniz-Aviles, Ahmed Hakawi, Hajime Kamiya, Andromachi Karachaliou, Jay Lucidarme, Susan Meiring, Konstantin Mironov, Sáfadi Marco A P MAP 0000-0002-4401-9446 o Department of Pediatrics , FCM Santa Casa de São Paulo School of Medical Sciences , São Paulo , Brazil., Zhujun Shao, Vinny Smith, Robert Steffen, Bianca Stenmark, Muhamed-Kheir Taha, Caroline Trotter, Julio A Vázquez, and Bingqing Zhu.
• a Biologic Evaluation Department , Finlay Institute of Vaccines , Havana , Cuba.
• Expert Rev Vaccines. 2019 Jan 1; 18 (1): 15-30.

IntroductionThe 2018 Global Meningococcal Initiative (GMI) meeting focused on evolving invasive meningococcal disease (IMD) epidemiology, surveillance, and protection strategies worldwide, with emphasis on emerging antibiotic resistance and protection of high-risk populations. The GMI is comprised of a multidisciplinary group of scientists and clinicians representing institutions from several continents.Areas CoveredGiven that the incidence and prevalence of IMD continually varies both geographically and temporally, and surveillance systems differ worldwide, the true burden of IMD remains unknown. Genomic alterations may increase the epidemic potential of meningococcal strains. Vaccination and (to a lesser extent) antimicrobial prophylaxis are the mainstays of IMD prevention. Experiences from across the globe advocate the use of conjugate vaccines, with promising evidence growing for protein vaccines. Multivalent vaccines can broaden protection against IMD. Application of protection strategies to high-risk groups, including individuals with asplenia, complement deficiencies and human immunodeficiency virus, laboratory workers, persons receiving eculizumab, and men who have sex with men, as well as attendees at mass gatherings, may prevent outbreaks. There was, however, evidence that reduced susceptibility to antibiotics was increasing worldwide.Expert CommentaryThe current GMI global recommendations were reinforced, with several other global initiatives underway to support IMD protection and prevention.

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