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What Parents of Every Teen Should Know About Meningitis

The most important thing parents of teens need to know about meningococcal disease is that it can be very serious.  And by serious, we mean debilitating and often deadly.

Even with prompt medical treatment, about 1 in 10 people with meningococcal disease will die from it. Of those who survive, about 1 to 2 will have permanent disabilities such as brain damage, hearing loss, loss of kidney function or limb amputations.

The best thing parents can do to protect their children from meningococcal disease is to get them vaccinated against all of the preventable forms of the disease.

 What causes meningitis and meningococcal disease?

Meningitis refers to a swelling of the protective membranes that cover the brain and spinal cord.   While meningitis is commonly caused by a bacterial or viral infection, it can also be caused by injuries, cancer, certain drugs, and other types of infections.

Meningococcal disease is specific to any illness caused by the bacterium Neisseria meningitidis (also referred to as meningococcus or meningococcal meningitis).  These types of infections can cause meningitis, but can also cause bloodstream infections (known as bacteremia or septicemia).

It’s possible to have meningitis without having meningococcal disease, and it’s possibly to have a type of meningococcal disease that isn’t necessarily meningitis.  The specific cause of illness is important to identify because the treatment differs depending on the cause.

  • Bacterial forms of meningitis can be extremely dangerous and fast-moving and have the greatest potential for being fatal. The long-term effects of bacterial meningitis can include multiple amputations, hearing loss and kidney damage. Many, but not all, forms of bacterial meningitis can be prevented by vaccination.
  • Viral meningitis has similar symptoms to bacterial meningitis, but for the most part is neither as deadly nor as debilitating. There is no specific treatment available for viral meningitis, but most patients fully recover over time.
Meningococcal Disease Facts

Who is at risk?

While anyone can contract meningococcal disease, adolescents and young adults are among the population who have a higher risk for the disease due to their lifestyle factors.  For instance, the risk of meningococcal is higher for those who are living in crowded settings such as college dormitories, boarding schools, sleep-away camps or military barracks. Other factors that can raise the risk of infection include:

  • Attendance at a new school with students from geographically diverse areas
  • Irregular sleeping patterns
  • Active or passive smoking
  • Social situations where there is crowding
  • Moving to a new residence

How is it spread?

About one in ten people carry meningococcal bacteria in their nose or throat without showing any signs or symptoms of the disease. These people can unknowingly transmit the bacteria to others through the exchange of respiratory secretions during close or lengthy contact with someone’s saliva, such as through kissing or coughing, especially if they are living in close quarters.  Although meningococcal bacteria are very dangerous, they cannot live outside the body for very long.  This means that while contagious, the infection is not as easily spread as a cold virus.

How can it be prevented?

Currently, vaccination is the best defense against meningococcal disease. There are five major serogroups of meningococcal disease (A, C, W, Y and B). The three most commonly seen in the United States are B, C and Y, with one-third of all cases in the U.S. being of serogroup B.

In order to be protected against all the preventable strains of meningococcal disease, teens need to receive multiple doses of two different kinds of meningococcal vaccines.

Meningococcal Conjugate Vaccine (MenACWY):  Routine vaccination with the conjugate is recommended at age 11-12 to protect against serogroups A, C, W and Y. Adolescents should also get a vaccine booster dose at age 16.

Meningococcal Serogroup B Vaccine (MenB): This vaccine is recommended for people 10 years or older who are at increased risk for serogroup B meningococcal infections including:

  • People at risk because of a serogroup B meningococcal disease outbreak.
  • Anyone whose spleen is damaged or has been removed.
  • Anyone with an immune system condition known as “persistent complement component deficiency”.
  • Anyone taking a drug called eculizumab (Soliris).
  • Microbiologists who routinely work with N. meningitidis isolates.

The CDC also recommends permissive use of the MenB vaccine for adolescents and young adults age 16-23, with a preferred age of 16 to 18. A permissive recommendation means that it is at a doctor’s discretion whether they will recommend the vaccine to those who don’t fall into the categories listed above.  If a provider doesn’t feel the patient is at risk, they may fail to mention the availability of the vaccine.

This does not mean that a parent can’t request or receive the vaccine for their child.    

It’s critical that parents understand that serogroup B meningococcal disease is not only the most common cause of meningococcal disease in adolescents and young adults, but it has also cause several outbreaks on college campuses over the past few years.

Meningococcal Disease on U.S. College Campuses, 2013-2017

Graphic compiled by the National Meningitis Association

The vaccine has been deemed safe by the FDA, and has been recommended by the CDC, so parents should feel comfortable getting the vaccine for their child, especially if they feel they are at risk of exposure.  If a child is attending college, parents may want to take the precaution of getting them vaccinated before they arrive on campus.  In the case of an outbreak, the vaccine will be recommended.  However, if your child is exposed before the outbreak is identified than it may be too late to benefit from the vaccine.

What are the symptoms and can it be treated?

The symptoms of meningococcal disease are the same for all of the serogroups.  Unfortunately, it is not easy for healthcare professionals to identify and diagnose the infection in its early stages and it’s often mistaken for the flu or other viral infections.  Symptoms tend to develop over several hours or over one or two days, and may include:

  • Sudden high fever
  • Severe headache
  • Stiff neck
  • Vomiting or nausea with headache
  • Confusion or difficulty concentrating
  • Seizures
  • Sleepiness or difficulty waking up
  • Sensitivity to light
  • Lack of interest in drinking and eating
  • Skin rash

Meningococcal disease can be treated with antibiotics, but treatment must begin early to be effective. Even if treatment is started as soon as possible, it might not prevent death or serious long-term complications such as hearing loss, brain damage, kidney disease or limb amputations.

Today we are grateful for moms like the ones featured in this video who are helping to raise awareness about the two available meningococcal vaccines for adolescents and young adults. May their stories help parents to make educated decisions about disease prevention.

Visit the following websites for more information on the dangers of meningitis and how it can be prevented.

Vaccinate Your Family – PreTeens & Teens Meningococcal Disease

National Meningitis Association

The Kimberly Coffey Foundation

The Emily Stillman Foundation

Meningitis Angels

Make Sure Your College Student Has These Shots Before Returning To Campus

iStock_000078067721_Double.jpgTeens and young adults have a tendency to believe they’re completely invincible.  But their lifestyle – which often involves high levels of stress, inadequate amounts of sleep and close living quarters – can put them at an increased risk of certain infections such as flu, mumps, meningitis and HPV.  As students return to class after winter break, they’re  reunited with classmates, roommates, and professors who may have been exposed to infectious diseases during their travels to other states or other countries.

While it’s impossible to prevent every cough and sniffle, parents can help protect their kids by ensuring they’re up-to-date on all their recommended vaccines.

So what are all the vaccines that are recommended for teens and young adults?  

And wouldn’t they be required for school anyway?

Vaccine requirements vary by state and don’t necessarily include all the vaccines that the CDC recommends. Therefore, as winter break come to an end, parents should review their students’ immunization records and arrange for them to get any missing shots before they return to class.

Here are a few of the diseases that students should be protected against.

Influenza

Influenza is a dangerous viral infection that causes hundreds of thousands of hospitalizations and thousands of deaths each year in the U.S., even among health people of all ages.  For the best protection, the CDC recommends that everyone over the age of 6 months receive an annual influenza vaccine.

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Unfortunately, while flu vaccination rates are typically the highest among children, rates tend to drop among teens and young adults. If your college student hasn’t already received their annual flu vaccine it’s not too late.  Bring them to their healthcare provider or local pharmacy to get them protected before they return to campus. Although it can take up to two weeks to develop antibodies post-vaccination, flu season often extends well into Spring, so students will benefit from protection for many months to come.

Mumps

Mumps may not be considered “common” in the U.S. thanks to a 99% decrease in mumps cases once mumps vaccination began in 1967, but there have been several mumps outbreaks on college campuses in the past year, and approximately 4,258 cases across 46 states and DC in 2016.

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This shouldn’t come as much of a surprise when you consider that crowded environments, such a large classes and dormitory living can all contribute to the likelihood of outbreaks.  Also, since mumps is spread primarily through saliva, coughing and sneezing, teen behaviors such as kissing or sharing plates, utensils, cups, lipstick or cigarettes, are all factors that can increase the likelihood of transmission. Read more…

Stories of Polio, Meningitis, HPV, Hepatitis and Pertussis Top 2016 List

December 28, 2016 Leave a comment

Every Child By Two’s online platforms have reached over 11 million people with evidence based vaccine messaging in 2016.  As we look back at the record number of views and shares there have been on Shot of Prevention blog posts this past year, we’re especially grateful to our blog readers, contributors and subscribers.  

Whether you have shared a post, shared your story, or shared your expertise, know that our growth and success would not have been possible without your support.  Thanks to you, people are referencing our content before making important immunization decisions for themselves and their families.  In these final days of 2016, we hope that you will revisit these top five posts from the past year and share them with others in your social networks.  Together, we can continue to engage more people in these important immunization discussions.

 

1. My Polio Story is an Inconvenient Truth to Those Who Refuse Vaccines


Judy Post Polio with SisterIn 1949, Judith contracted polio along with 42,000 other people in the U.S. Judith survived five months in the hospital and multiple surgeries, but sadly 2,720 people died from polio that year.  As Judith bravely shares her story, she explains that it represents an inconvenient truth to people who are in denial about the risks of polio. She is continually shocked by people who refuse vaccines, who refuse to believe she ever suffered with polio, or who actually believe the polio vaccine is part of a government or “big pharma” conspiracy.  By sharing Judith’s story we hope to encourage continued polio vaccination and support of polio eradication worldwide and applaud people like Judith who are courageous enough to speak out in support of vaccines.  To read Judith’s story, click here.

 

2. How My Vaccinated Daughter Died From Meningitis and What I’m Doing About It  


EmilyStillmanEmily Stillman was pronounced brain-dead just 30 hours from the onset of a severe headache.  What they though was a migraine turned out to be meningococcal disease. In this post Emily’s mother Alicia explains that although Emily received a meningococcal vaccine, the MCV4 vaccine she received only protected her against meningococcal serogroups A, C, W and Y.  It did not protect her against serogroup B, which is what caused Emily’s death.  Since Emily’s death, a MenB vaccine has been approved for use.  However, most parents still don’t know it exists and therefore, most students are still not protected.

As the Director of The Emily Stillman Foundation, Alicia Stillman helps educate people about the importance of “complete and total” protection against all serogroups of meningococcal disease.  This means ensuring that teens and young adults receive both meningococcal vaccines; the MCV4 vaccine that protects against serogroups A,C, W and Y, as well as a MenB vaccine series.  To learn more about fully protecting our youth against meningococcal disease, read Alicia’s guest blog here.

 

3. Questioning Whether to Get Your Child the HPV Vaccine? Read This


hpv-fact-vs-fiction-series-1Although the HPV vaccine is one of the most effective ways we have to prevent numerous types of cancer, it is still being grossly underutilized.  As a result of persistent but inaccurate myths circulating on the internet, some parents are more fearful of the HPV vaccine than the human papillomavirus itself.  This is causing them to refuse or delay HPV vaccination for their children.

In this popular blog post, we highlight ten critical facts that address the most common misconceptions about HPV infection and the vaccine that can help prevent this very common infection. To learn more, be sure to read the post here.

 

4. Understanding Why Your Baby Needs a Hepatitis B Vaccine at Birth  


 

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There are many misconceptions about hepatitis B and how the infection is transmitted.  Because of this, many parents don’t consider their children to be at risk of infection and so they question the need for a hepatitis B vaccine at birth.  In this post, the Prevent Cancer Foundation explains the connection between hepatitis B and liver cancer and discusses ways in which infants and children can unknowingly contract hepatitis B.  Their Think About the Linkeducation campaign suggests that vaccinating infants before they leave the hospital is a critical first step in protecting your newborn from a virus that can lead to cancer later in life.  To learn more about Hepatitis B and the vaccine to prevent it, click here.

 

5. Barbara Loe Fisher is Right.  She’s Also to Blame. 


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Back in the 1980’s, Barbara Loe Fisher claimed that the whole cell pertussis vaccine (DTP)  was dangerous and causing too many adverse events.  Her complaints prompted the development of the more purified (acellular) pertussis vaccines that we use today; DTaP for infants, and Tdap for adolescents and adults. While studies have shown that these newer vaccines are not as effective as the old whole cell pertussis vaccine, they are the best protections we have against the dangers of pertussis.

Unfortunately, those who need protection the most are those who are too young to be vaccinated.  Infants are at high risk of severe complications from pertussis, to include hospitalization and death, but babies don’t begin receiving pertussis vaccine until two months of age.  After newborn Calle Van Tornhout contracted pertussis from a hospital nurse at birth, she died at just 37 days of age.  Callie’s death has had her home state of Indiana considering a bill that would mandate pertussis vaccination among health care workers.  But Barbara Loe Fisher is opposed to that as well.  To read more about the history of pertussis vaccines, click here.

 

If you have suggestions for topics you would like us to address in 2016, or you would like to contribute a guest post for publication, please email shotofprevention@gmail.com.  

Don’t miss any of our new posts.   Subscribe to Shot of Prevention by clicking the link at the top right of this page.  You can also “Like” our Vaccinate Your Family Facebook page to receive updates on important immunization news and join in our online discussions.   

Thanks again for your continued support and best wishes for a happy and healthy new year!

October Updates from Advisory Committee on Immunization Practices

October 26, 2016 3 comments

10693.jpgLast week, the Advisory Committee on Immunization Practices (ACIP) held it’s third and final meeting of 2016.  The agenda included presentations pertaining to hepatitis B, pertussis, HPV, meningococcal, herpes zoster, pneumococcal and RSV vaccines, and surveillance updates on Zika and influenza viruses.

During the two-day meeting, the committee took nine votes on newly proposed vaccine recommendations that addressed vaccination timing, number of doses needed, and dosing intervals for hepatitis B, pertussis, HPV and meningococcal vaccines.  They also approved the child, adolescent and adult immunization schedules.

This post provides a recap of each agenda item in the order they occurred. 

Hepatitis B Vaccine

The recommended first dose of the three-series hepatitis B vaccine is often referred to as “birth dose” and is typically administered to infants in the hospital after birth.  At this meeting, the Hepatitis B Work Group asked that the Committee consider removal of the permissive language that appears at the end of the recommendation which allows for a delay of the birth dose until after hospital discharge.

When hepatitis B vaccine is administered within 24 hours of birth it can help prevent transmission of the hepatitis B virus from an infected mother to her child.  The intent of the birth dose is to provide an additional safety net to prevent transmission from HepB positive mothers that are not properly identified due to errors in maternal testing or reporting. In these instances, when the mother is not properly identified as HepB positive before birth, the HepB vaccine alone is 75% effective in preventing prenatal transmission, and 94% effective when used in conjunction with Hepatitis B immune globulin.

Since delaying hepatitis B vaccination can interfere with the prevention of Hepatitis B – especially in a child unknowingly born to a HepB positive mother – the HepB Work Group proposed that the reference to delaying vaccination be removed from the recommendation.  It had originally been added in 2005, but the data suggests that administering the birth dose in the hospital leads to timely completion of the series. The current birth dose coverage was stated to be 72.4% of children, which remains below the Healthy People 2020 goal of 84%.

The Committee voted to remove the permissive language as well as include new language to clarify that the first dose of vaccine should be administered within 24 hours of birth, which is more explicit than “before hospital discharge”.

The anticipated changes to the previous recommendation are indicated below, however the exact wording may differ once published by the CDC:

“For all medically stable infants weighing 2,000 grams or more at birth and born to HBsAg-negative mothers, the first dose of vaccine should be administered before hospital discharge within 24 hours of birth.  Only single antigen HepB vaccine should be used for the birth dose. On a case-by-case basis and only in rare circumstances, the first dose may be delayed until after hospital discharge for an infant who weighs 2,000 grams or more and whose mother is HBsAG-negative.

*It should be noted that for those infants with birth weight of less than 2,000 grams, the birth dose is not counted as part of the vaccine series.

There was some discussion concerning the removal of the option to delay vaccination and it was emphasized that having a clear recommendation from the ACIP is not a vaccine mandate.  Rather, practitioners, public health professionals and parents rely on the ACIP recommendations as expert guidance and best practice. The Hepatitis B “birth dose” has been a successful strategy to help eliminate hepatitis B virus transmission in the U.S., and the ACIP’s revised recommendations only emphasize the importance of vaccinating within the 24 hours timeframe that will help prevent further transmission.

stateoftheimmunion_hepb_fb_v2

Other key updates to the hepatitis B vaccine recommendations included:

  • Providing examples of chronic liver disease, including recommending HepB vaccine for persons with HCV infection.
  • Post vaccination serologic testing for infants who’s mother’s HBsAg status remains  unknown indefinitely.
  • Testing HBsAg-positive pregnant women for HBV DNA.

For more information as to why babies need a Hepatitis B vaccine at birth, read these Shot of Prevention blog posts here

Pertussis Vaccine

The Committee reviewed the history of Tdap vaccination in pregnant women and reviewed studies that found that maternal Tdap vaccination to both safe and effective at preventing infant pertussis. Read more…

I Want Parents to Know About the Additional Meningococcal Vaccine That Could Have Saved My Daughter

August 25, 2016 1 comment
This guest post has been written by Patti Wukovits, a Registered Nurse and Executive Director of The Kimberly Coffey Foundation, as part of National Immunization Awareness Month’s week-long focus on the importance of preteen and teen vaccination.

PattiAndKimberlyCoffey

As a mother and a nurse, I was vigilant in having both of my children up-to-date on all recommended vaccinations, including meningococcal vaccination. I was under the common misconception, as many parents are, that the meningococcal vaccine that my daughter received would fully protect her from meningococcal disease, when in fact, it didn’t protect her against meningitis B. The meningococcal vaccine (MCV4) only protects against four of the five common groups (ACWY), leaving adolescents and young adults vulnerable to meningitis B. Meningitis B is a type of bacterial meningitis, also known as meningococcal disease, which is a potentially fatal bacterial infection that can kill a healthy person within 24 hours.KimberlyCoffey

When my daughter Kimberly Coffey died in 2012 from bacterial meningitis, a vaccine was not available to protect her. But since 2014, meningitis B vaccination has been available in the United States. Kimberly was a perfectly healthy 17-year-old high school senior, and I believe she would be alive today if meningitis B vaccination had been available to her.

I established The Kimberly Coffey Foundation in Kimberly’s honor to educate other parents and health care providers about meningitis B, also known as MenB.

It’s critical that parents know that MenB vaccination is now available, and that without requesting MenB vaccination in addition to the common meningococcal vaccine (MCV4), their child will not be fully protected against meningococcal disease and MenB.

The Kimberly Coffey Foundation has partnered with Pfizer on the National Meningococcal Disease Awareness Survey to gain a better understanding of parents’ knowledge of meningococcal disease and its available vaccines.  This 2016 survey revealed that nearly 4 out of 5 parents didn’t know their child wasn’t fully immunized against the five common groups of meningococcal disease unless they had two meningococcal vaccines (MCV4 and MenB).

The bottom line is this – without adding MenB vaccination, we are going to lose more lives. There will continue to be more college outbreaks, especially since MenB has been responsible for several recent college outbreaks in the United States.  According to data released by the CDC, MenB currently accounts for approximately 50% of meningococcal disease in the United States among persons aged 17-22 years old. MenB vaccination is available for individuals ages 10-25, and public health insurance and most private insurance plans provide coverage.  However, your child’s provider may not mention it.

I want parents to have the knowledge to request MenB vaccination, in addition to the meningococcal vaccine, so that their children can potentially be fully protected against this devastating disease.

As a mother who lives every day with the heartache of not seeing my beautiful daughter live the full life she deserved, I know only too well how important MenB vaccination is. My daughter Kimberly’s life was one too many lost to this terrible disease.

KimberlyCoffeyFoundationLogoI will be Kimberly’s voice as I continue to promote awareness of meningococcal disease, which includes MenB. I don’t ever want another parent to experience what I have. And more important, I don’t want another person to experience what Kimberly did when she battled for her life.

Kimberly contracted MenB two years too early—two years before the MenB vaccine was made available.  She didn’t have the protection of the MenB vaccination, but your children can. Please protect your children – because YOU can.

 

For more information about meningitis B and the MenB vaccine, please visit the Kimberly Coffey Foundation at www.kimberlycoffeyfoundation.org.

 


Every Child By Two (host of the Shot of Prevention blog) welcomes guest blog posts on a variety of vaccine related issues.  The views and opinions expressed in these guest posts do not necessarily represent the views of the Every Child By Two organization.

How My Vaccinated Daughter Died From Meningitis and What I’m Doing About It

February 2, 2016 8 comments
This is a guest post, written by Alicia Stillman, Director of the Emily Stillman Foundation.  One of the missions of the Foundation is to raise awareness of meningococcal disease and the various vaccines that are now available to prevent it.    

February 2, 2013 my life changed forever.  I was told my beautiful and healthy nineteen year old daughter no longer had any brain activity, and that she would die.  Those words will forever haunt me.  There is no preparation, no training, and no practice for what was to come.  The loss of a child is like none other.  It is the wrong order. When you lose a child, a piece of you dies as well.

EmilyStillman

Emily was a sophomore at Kalamazoo College when she tragically contracted bacterial meningitis.  On February 2nd, 2013, Emily passed away with her family by her side.  Emily was able to donate 6 of her organs to 5 recipients, along with tissue and bones to countless others.

On January 31, 2013 my middle daughter Emily called home from college, and mentioned she had a headache.  I thought she was possibly coming down with the flu.  She thought it may be from lack of sleep.  We decided she would take Motrin and go to bed.  Several hours later she woke up to increased pain and was taken to the hospital where she was treated for a migraine.  It was not until hours later that the medical professionals realized they may be looking at meningococcal disease, and performed a lumbar puncture to confirm.

The entire two hour drive to the hospital I begged the medical professionals to double check the results.  Since I knew my daughter had been vaccinated against meningitis, I did not believe it was possible for her to have that disease.  I feared that something else would go untreated, and I wanted them to heal her.

When I arrived at the hospital, Emily was already unconscious as they prepared her for a craniotomy to relieve the swelling in her brain.  When the nurse took me to see her, she asked if I wanted them to call clergy.  That was the first time I actually realized the seriousness of this disease.  I did not understand how this could be happening.  My daughter only had a headache.  She was vaccinated.

Within 30 hours from the onset of her headache, my daughter was brain dead.  Her life was over.  We decided Emily would want to be an organ donor.  She was able to save five lives with six organs, and countless others with her bones and tissue.  She was a hero.

StillmanFamily2As I said goodbye to my sweet daughter in that hospital bed, I made her a promise.  Read more…

Dr. Schaffner Helps Clear Up the Confusion on Meningococcal Vaccines

October 30, 2015 Leave a comment

Since outbreaks of meningococcal serogroup B began occurring on various college campuses late last year, resulting in several student deaths, there has been a lot of interest in a new meningococcal serogroup B vaccine. One of the biggest challenges that have come along with the introduction of this new vaccine is that parents are confused about the offering of two different meningococcal vaccines that prevent various strains of meningococcal disease.

Featured Image -- 7456To complicate matters, the Advisory Committee on Immunization Practices (ACIP) issued a “permissive recommendation” for the new serogroup B vaccine, which many suggest will make doctors less likely to recommend the vaccine to all their patients, but will allow parents to request the vaccine for their child.

Fortunately, Dr. William Schaffner wrote an excellent article for the National Foundation of Infectious Diseases (NFID) that we have reblogged below that provides a thorough explanation of meningococcal disease, the different meningococcal vaccines that are available to patients, and the facts parents need to know to make an educated immunization plan for their child.

NFID News

Special thanks to William Schaffner, MD, NFID Medical Director and Professor of Preventive Medicine and Infectious Diseases at Vanderbilt University School of Medicine, for this guest blog post on the recently published Advisory Committee on Immunization Practices (ACIP) meningococcal serogroup B immunization recommendation.

Parents usually rely on their child’s pediatrician to keep them up-to-date on vaccines. But the updated meningococcal vaccine recommendation recently issued by the Centers for Disease Control and Prevention (CDC) is different. The new recommendation paves the way for adolescents and young adults to get vaccinated against a rare, but deadly infection called serogroup B meningococcal disease–but it puts more responsibility on parents to seek and request the vaccine.

Meningococcal disease is a bacterial infection that causes meningitis (brain swelling) or sepsis (blood infection). Serogroup B is just one of several types of bacteria that cause the disease. Four other serogroups (A, C, W, and Y) are…

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