人類是腦膜炎雙球菌在自然界中唯一的天然宿主

傳染病有紀錄至少100年，但疫苗最近幾年才陸續到位。

「流行性腦脊髓膜炎」在世界各地都有疫情，特別是在非洲已經流行超過100年了，從1960年代開始，全世界使用疫苗讓疾病發生率大幅下降，大多數侵襲性流行性腦脊髓膜炎的病例由6種血清型引起，分別為A、B、C、W、X、Y，疫苗是根據這些血清型所研發；該接種哪種疫苗，可以參考居住地或即將前往旅遊的地點之好發血清型來施打，以台灣為例，過去15年的統計資料顯示發病者有80%為B型的感染，而且和許多國家一樣，小於一歲的嬰兒B型的感染比其他血清型還高，因此會特別建議嬰兒接種B型腦膜炎球菌疫苗。B型腦膜炎球菌疫苗有別於ACWY型的多醣體疫苗在過去難以開發出適當疫苗，隨著科技進步，新型B型腦膜炎球菌疫苗終於在2013年陸續上市歐美，台灣也在2021年6月核准通過藥品許可證的申請，希望藉由疫苗接種減少遺憾發生！

http://www.cmuch.org.tw/NewsInfo/NewsArticle?no=563

歐美台灣的疫苗是Ｂ型，其他地方是ACWY。

「非洲流腦帶」

腦膜炎歷史淵源上常被提到與麥加朝聖後返回非洲者有關。 但其實最早的紀錄是歐洲的維也納。然後相近日期是美國麻州。然而一百年來慘烈的是非洲。抗生素濫用反而讓細菌有了抗藥性。

Meningococcal disease was first described in the late winter and spring in Geneva, Switzerland, in 1805, as “an epidemic outbreak of rapid onset, hemorrhagic eruption, febrile course, and high mortality with gross inflammation of the central nervous system.”⁷ In 1806, a similar epidemic outbreak was reported in New Bedford, Massachusetts,⁸ and, subsequently, outbreaks occurred across Europe and in the United States over the next several decades. Curiously, no description of this singular epidemic disease was reported prior to 1805 nor were there reports of epidemics in the meningitis belt of sub-Saharan Africa before about 1900,⁹ giving rise to speculation that this was, at the time, a new emerging disease.

David S. Stephens, Michael A. Apicella, in Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases (Eighth Edition), 2015

也是十九世紀末被分離出來，然後是在紐約市才有血清的治療，之後要等到60年代的疫苗。

Marchiafava and Celli¹⁰ (1884) first described intracellular oval micrococci in cerebrospinal fluid (CSF), and Anton Weichselbaum¹¹ (1887) identified and cultured the organism, which he named Diplococcus intracellularis meningitidis because of its presence inside neutrophils from CSF, thus establishing the etiologic relationship between this organism and epidemic meningitis. Kiefer,¹² in 1896, and Albrecht and Ghon,¹³ in 1901, found that healthy persons could become nasopharyngeal carriers of the meningococcus. Outbreaks of meningococcal meningitis in New York City in the early 1900s led to the introduction of equine serum therapy for the treatment of meningococcal infection in 1907 by Flexner.¹⁴ 

https://www.sciencedirect.com/science/article/pii/B9781455748013002137

疫苗不平等是最大的原因。

Meningococcal epidemics in sub-Saharan Africa have occurred for 100 years (Greenwood, 1999) as large outbreaks at a frequency of 5–10 years or smaller yearly outbreaks in a region of over 18 countries described as the meningitis belt (Lepeyssonnie, 1963). Other regions of Africa also have high rates of meningococcal disease. Thousands of cases occur in the United States, Canada, Europe, parts of South America, Australia, New Zealand, and China. Up to 70–85% of cases were fatal in the pre-serum therapy and pre-antibiotic eras; today, the overall mortality rate in meningococcemia remains high, between 10% and 15% (Sharip et al., 2006).

https://www.sciencedirect.com/science/article/pii/B9780123694089000536

流行性腦脊髓膜炎疫苗簡介

流行性腦脊髓膜炎疫苗是一種不活化疫苗，現用疫苗(商品名Menveo，腦寧安)是純化A、C、W-135、Y四種血清型細菌的細胞壁多醣體後，以白喉桿菌蛋白作為載體蛋白，結合製成疫苗，對其他血清型的腦膜炎雙球菌(如B型)並沒有保護效果。