Evolution of invasive meningococcal disease epidemiology in Europe, 2008 to 2017

Abstract

Background Invasive meningococcal disease (IMD) epidemiology has fluctuated over the past 25 years and varies among serogroups, age groups and geographical locations. Aim This study analysed the evolution of European IMD epidemiology from 2008 to 2017 to identify trends. Methods Reported number of IMD cases and associated incidence were extracted from the European Centre for Disease Prevention and Control Surveillance Atlas for Infectious Diseases for individual European countries. Epidemiology and its evolution were analysed by serogroup and age group. Results Overall IMD incidence decreased by 34.4% between 2008 and 2017. Serogroup B remained predominant in 2017; despite a 56.1% decrease over the 10-year period, the rate of decrease has slowed in recent years and varies by age group. Serogroup C was the second most prevalent serogroup until 2016. Its incidence decreased among individuals aged 1–24 years, the main population targeted by MenC vaccination campaigns, but increases have occurred in other age groups. Incidences of serogroups W and Y were low but increased by > 500% and > 130% (to 0.10 and 0.07/100,000) respectively, from 2008 to 2017. Considering all serogroups, a marked modification of the evolution trends by age group has occurred, with increases in incidence mainly affecting older age groups. Conclusion Although the overall IMD incidence decreased in Europe between 2008 and 2017, increases were observed for serogroups W and Y, and in the older population when considering all serogroups. It may be necessary to adapt current vaccination strategies to reflect epidemiological changes and their likely future evolution.

Outbreak of invasive meningococcal disease caused by a meningococcus serogroup B in a nursery school, Wallonia, Belgium, 2018

“…Invasive meningococcal disease (IMD) is a serious life-threatening illness and, in 2017, had a case fatality rate of 9.7% in the European Union/European Economic Area (EU/EEA) countries. Data from several high-income countries has shown a severe long-term burden of disease with major sequelae in 10-20% of survivors [1][2][3][4]. IMD is caused by Neisseria meningitidis, a Gram-negative bacterium present in the nasopharynx of healthy carriers, which is transmitted through droplets of respiratory or throat secretions.…”

“…The disease mainly affects infants (< 1 year) and young children (1–4 years). Although IMD remains relatively rare in the EU/EEA, with notification rates of 0.6 cases per 100,000 population in 2017 [ 1 ], its severity and outbreak potential make it a major public health problem. Of the 12 serogroups, A, B, C, W, Y and X cause most IMD cases worldwide [ 5 ].…”

“…Of the 12 serogroups, A, B, C, W, Y and X cause most IMD cases worldwide [ 5 ]. Despite decreasing trends, serogroup B remains the predominant serogroup in the EU/EEA, accounting for over 50% of cases overall in 2017 and for 70% of cases in children under 5 years of age [ 1 ].…”

“…• The most at-risk period for meningococcal infections is between ages 0-5 years [1][2][3], so the children affected by this cluster were in the process of exiting this risk period.…”

Estimation of the incidence of invasive meningococcal disease using a capture–recapture model based on two independent surveillance systems in Catalonia, Spain

“…Six serogroups (A, B, C, W, X, Y) currently cause almost all cases of this life-threatening disease worldwide. Case fatality rate is about 10% in developed countries,4–6 and 40%–65% present with meningitis, but meningococcemia and pneumonia are also frequent,4 being the serogroup involved related both with the case fatality rate7 and the predominant clinical form 8. Serogroup B causes more than a third part of IMD,4 9 but in some countries or population groups the proportion is even higher 10 11.…”