MeNZB
Encyclopedia
MeNZB was a vaccine
Vaccine
A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine typically contains an agent that resembles a disease-causing microorganism, and is often made from weakened or killed forms of the microbe or its toxins...

 against a specific strain of group B meningococcus, used to control an epidemic of meningococcal disease in New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...

. Most people are able to carry the meningococcus bacteria safely with no ill effects. However, meningococcal disease can cause meningitis
Meningitis
Meningitis is inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. The inflammation may be caused by infection with viruses, bacteria, or other microorganisms, and less commonly by certain drugs...

 and septicaemia, resulting in brain damage, failure of various organs, severe skin and soft-tissue damage, and death.

Immunisation with MeNZB requires three doses, administered approximately six weeks apart (except in newborns, who have them in conjunction with their 6-week, 3-month and 5-month injections). People who have been fully immunised may still carry the meningococcus bacteria and may still contract meningococcal disease.

Components

Each dose is 0.5 ml and contains:
  • 25 mcg of outer membrane vesicles from the Neisseria meningitidis
    Neisseria meningitidis
    Neisseria meningitidis, often referred to as meningococcus, is a bacterium that can cause meningitis and other forms of meningococcal disease such as meningococcemia, a life threatening sepsis. N. meningitidis is a major cause of morbidity and mortality during childhood in industrialized countries...

    group B strain NZ98/254. The vaccine does not contain any whole bacteria
    Bacteria
    Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

     (alive or dead). The "outer membrane vesicles" it contains are a small part of the "skin" of the bacteria that let the immune system recognise and prepare for being infected with the real thing. MeNZB vaccine does not contain any human, blood
    Blood
    Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....

    , or bovine (cow)products, egg
    Egg (food)
    Eggs are laid by females of many different species, including birds, reptiles, amphibians, and fish, and have probably been eaten by mankind for millennia. Bird and reptile eggs consist of a protective eggshell, albumen , and vitellus , contained within various thin membranes...

     products, neomycin
    Neomycin
    Neomycin is an aminoglycoside antibiotic that is found in many topical medications such as creams, ointments, and eyedrops. The discovery of Neomycin dates back to 1949. It was discovered in the lab of Selman Waksman, who was later awarded the Nobel Prize in Physiology and medicine in 1951...

     or the preservative thiomersal (mercury). There are no live meningococcal bacteria in the vaccine and it is not possible to catch the disease or become a carrier of the disease from the vaccine.

  • 1.65 mg of aluminium hydroxide
    Aluminium hydroxide
    Aluminium hydroxide, Al3, ATH, sometimes erroneously called Hydrate of alumina, is found in nature as the mineral gibbsite and its three, much more rare forms, polymorphs: bayerite, doyleite and nordstrandite. Closely related are aluminium oxide hydroxide, AlO, and aluminium oxide, Al2O3,...

     (an adjuvant
    Adjuvant
    An adjuvant is a pharmacological or immunological agent that modifies the effect of other agents, such as a drug or vaccine, while having few if any direct effects when given by itself...

    ). The immune system will normally not mount an immune response to the outer membrane vesicles if they are presented alone. The presence of the adjuvant forces the immune system to respond to the membrane vesicles by acting to prevent their breakdown and elimination, while causing local tissue damage to provoke the desired immune reaction.

  • histidine
    Histidine
    Histidine Histidine, an essential amino acid, has a positively charged imidazole functional group. It is one of the 22 proteinogenic amino acids. Its codons are CAU and CAC. Histidine was first isolated by German physician Albrecht Kossel in 1896. Histidine is an essential amino acid in humans...

     (to stabilise the pH
    PH
    In chemistry, pH is a measure of the acidity or basicity of an aqueous solution. Pure water is said to be neutral, with a pH close to 7.0 at . Solutions with a pH less than 7 are said to be acidic and solutions with a pH greater than 7 are basic or alkaline...

    ). The histidine pH buffer is to ensure the vaccine stays as close as possible to the pH of human body fluids. This is to ensure the immune system does not waste time trying to neutralise the vaccine instead of responding to the outer membrane vesicles.

  • normal saline
    Saline (medicine)
    In medicine, saline is a general term referring to a sterile solution of sodium chloride in water but is only sterile when it is to be placed intravenously, otherwise, a saline solution is a salt water solution...

    . The saline (sterile salt and water) is also like packaging. It is required so that all of the above can be dissolved into a solution that can be injected. It is the same salinity (saltiness) as normal human body fluid.


The antigen in MeNZB is prepared from B:4:P1.7b,4 (NZ 98/254 ) N. meningitidis strain, grown in a fermentor. The bacteria are grown in a synthetic culture medium containing sugar, essential amino acids and essential elements such as iron and potassium. The fermentation does not use bovine or porcine products. The cellular outer membranes are extracted with the detergent deoxycholate, which kills the bacteria. Outer membrane vesicles are purified out of the culture medium by ultracentrifugation, stabilised by histidine and then adsorbed to aluminium hydroxide Al(OH)3 as an adjuvant. Purification is achieved by ultrafiltration/diafiltration.

Impact

Since its introduction the vaccine has had a dramatic impact on the epidemic. In April 2008 it was unexpectedly announced by the New Zealand Ministry of Health that the MeNZB vaccination programme will be completed by 31 December 2008, and that after this period vaccination would require authorization of a GP. Reasons given for this halt of the programme include that the epidemic was coming to an end, and that immune protection given by the vaccine is only short-term. Others speculate that the cost of providing the vaccine is too high for the NZ government to justify.

The vaccine, originally developed in Norway
Norway
Norway , officially the Kingdom of Norway, is a Nordic unitary constitutional monarchy whose territory comprises the western portion of the Scandinavian Peninsula, Jan Mayen, and the Arctic archipelago of Svalbard and Bouvet Island. Norway has a total area of and a population of about 4.9 million...

 and subject to considerable public controversy as recently as October 2007, was never released for widespread use in that country because the Norwegian epidemic
Epidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

was finishing before it was released.

External links

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