Increased incidence of invasive meningococcal disease of serogroup C / clonal complex 11, Tuscany, Italy, 2015 to 2016

Stefanelli, Paola; Miglietta, Alessandro; Pezzotti, Patrizio; Fazio, Cecilia; Neri, Arianna; Vacca, Paola; Voller, Fabio; D’Ancona, Fortunato; Guerra, Ranieri; Iannazzo, Stefania; Pompa, Maria Grazia; Rezza, Giovanni

doi:10.2807/1560-7917.es.2016.21.12.30176

Cited by 43 publications

(48 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Immunisation campaigns have been implemented as a result, continuously adapting them to the evolution of the epidemiological situation, and IMD surveillance activities have been enhanced. 7 MenC is the second most common serogroup in Italy (accounting for 31% of the 115 cases with a known serogroup in 2014) after MenB (with 48% of the 115 cases in 2014), while MenY is the third cause of meningococcal infection (13% of the serogroups typed in 2014). 8 Based on 2014 data, in Veneto (northeast Italy) the incidence of IMD is 0.35/100 000 population.…”

Section: Introductionmentioning

confidence: 99%

Invasive meningococcal disease in the Veneto region of Italy: a capture-recapture analysis for assessing the effectiveness of an integrated surveillance system

et al. 2017

View full text Add to dashboard Cite

BackgroundEpidemiology of Neisseria meningitidis has been changing since the introduction of universal vaccination programmes against meningococcal serogroup C (MenC) and meningococcal serogroup B (MenB) has now become dominant. This study aimed to analyse the cases reported in institutional data recording systems to estimate the burden of invasive meningococcal diseases (IMDs) and assess the effectiveness of surveillance in Veneto region (Italy).MethodsAnalysis was performed from 2007 to 2014 on data recorded in different systems: Mandatory Notification System, National Surveillance of Invasive Bacterial Diseases System and Laboratories Surveillance System (LSS), which were pooled into a combined surveillance system (CSS) and hospital discharge records (HDRs). A capture-recapture method was used and completeness of each source estimated. Number of cases with IMD by source of information and year, incidence of IMD by age group, case fatality rate (CFR) and distribution of meningococcal serogroups by year were also analysed.ResultsCombining the four data systems enabled the identification of 179 confirmed cases with IMD, achieving an overall sensitivity of 94.7% (95% CI: 90.8% to 98.8%), while it was 76.7% (95% CI: 73.6% to 80.1%) for CSS and 77.2% (95% CI: 74.1% to 80.6%) for HDRs. Typing of isolates was done in 80% of cases, and 95.2% of the typed cases were provided by LSS. Serogroup B was confirmed in 50.3% of cases. The estimated IMD notification rate (cases with IMD diagnosed and reported to the surveillance systems) was 0.48/100 000 population, and incidence peaked at 6.2/100 000 in children aged <1 year old (60.9% due to MenB), and increased slightly in the age group between 15 and 19 years (1.1/100 000). A CFR of 14% was recorded (8.7% in paediatric age).ConclusionsQuality of surveillance systems relies on case ascertainment based on serological characterisation of the circulating strains by microbiology laboratories. All available sources should be routinely combined to improve the epidemiology of IMD and the information used by public health departments to conduct timely preventive measures.

show abstract

Section: Introductionmentioning

confidence: 99%

Invasive meningococcal disease in the Veneto region of Italy: a capture-recapture analysis for assessing the effectiveness of an integrated surveillance system

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Infection of infant rats with the wild-type strain caused severe bacteremia, while an isogenic mutant strain defective in capsule synthesis (but expressing a sialylated LOS) caused bacteremia only when a 10 6 -CFU-higher bacterial dose was used. In addition, when infant rats were infected with encapsulated meningococci that were unable to sialylate the LOS, bacteremia could never be induced, even with an infective dose as high as 10 8 CFU, suggesting that both forms of sialic acid on the bacterial cell surface are indispensable for systemic meningococcal survival in the infant rat model (7). Our study further expands these data to CNS infection dynamics, having in mind, however, all the limitations of an i.c.…”

Section: Discussionmentioning

confidence: 65%

“…In addition, since January 2015, in Tuscany, Italy, there has been an unexpected increase in cases of invasive meningococcal disease (a total of 43 cases, of which 10 were fatal) due to infection with serogroup C N. meningitidis. Thirty-five out of the samples analyzed in this study were confirmed as C:P1.5-1,10-8:F3-6:ST-11 (clonal complex [CC] 11) (8).…”

mentioning

confidence: 82%

Virulence Traits of a Serogroup C Meningococcus and Isogenic cssA Mutant, Defective in Surface-Exposed Sialic Acid, in a Murine Model of Meningitis

et al. 2019

View full text Add to dashboard Cite

In serogroup C Neisseria meningitidis, the cssA (siaA) gene codes for an UDP-N-acetylglucosamine 2-epimerase that catalyzes the conversion of UDP-N-acetyl-α-d-glucosamine into N-acetyl-d-mannosamine and UDP in the first step in sialic acid biosynthesis. This enzyme is required for the biosynthesis of the (α2→9)-linked polysialic acid capsule and for lipooligosaccharide (LOS) sialylation. In this study, we have used a reference serogroup C meningococcal strain and an isogenic cssA knockout mutant to investigate the pathogenetic role of surface-exposed sialic acids in a model of meningitis based on intracisternal inoculation of BALB/c mice. Results confirmed the key role of surface-exposed sialic acids in meningococcal pathogenesis. The 50% lethal dose (LD50) of the wild-type strain 93/4286 was about four orders of magnitude lower than that of the cssA mutant. Compared to the wild-type strain, the ability of this mutant to replicate in brain and spread systemically was severely impaired. Evaluation of brain damage evidenced a significant reduction in cerebral hemorrhages in mice infected with the mutant in comparison with the levels in those challenged with the wild-type strain. Histological analysis showed the typical features of bacterial meningitis, including inflammatory cells in the subarachnoid, perivascular, and ventricular spaces especially in animals infected with the wild type. Noticeably, 80% of mice infected with the wild-type strain presented with massive bacterial localization and accompanying inflammatory infiltrate in the corpus callosum, indicating high tropism of meningococci exposing sialic acids toward this brain structure and a specific involvement of the corpus callosum in the mouse model of meningococcal meningitis.

show abstract

“…The lack of statistical significance associated with the perception of dangerousness of meningitis between the two groups, could be attributed on one hand, to the media's echo that it has had in recent years. In fact, as happens during epidemic events, even during the recent meningitis emergency in Tuscany [25,26], it led health authorities to use also the mass media as institutional channels (which in our study were classified as "not institutional") for their rapidity and capillarity to reach the population. On the other, it could be attributed to the intrinsic high outrage level of meningococcal diseases, as recently evidenced [27].…”

Section: Discussionmentioning

confidence: 92%

Use of Information Sources on Vaccine-Preventable Diseases in Pregnant Women: An Experience in Ferrara, Italy

Gabutti

Carioli

Gamberoni

et al. 2019

IJERPH

View full text Add to dashboard Cite

The "vaccine hesitancy" and the consequent lowering of vaccination coverage have, on one hand, pushed the Italian government to reintroduce some new compulsory vaccinations for access to schools and, on the other, have imposed a greater effort on health operators to understand the causes and, consequently, to intervene with tools for promotion and health education. In Ferrara, we administered 201 non-self-filling questionnaires to 201 pregnant women within a cross-sectional multicenter study, consisting of 63 items divided into 7 sections. In particular, we wanted to investigate the correlation between the socio-demographic characteristics of the interviewees and the sources used to obtain information and, on the other side, the intention to vaccinate in relation to the perception of the diffusion and of the risk of vaccine-preventable diseases. The institutional information sources are less used by foreigners, primiparous, and women with a low education level. The perception of the severity of vaccine-preventable diseases was greater in those inquiring from institutional sources. In a public health perspective, knowing the profile of future mothers in terms of socio-demographic characteristics and of the quality of the used information channels may help to guide the choices of communication in the vaccination field.

show abstract

Increased incidence of invasive meningococcal disease of serogroup C / clonal complex 11, Tuscany, Italy, 2015 to 2016

Cited by 43 publications

References 7 publications

Invasive meningococcal disease in the Veneto region of Italy: a capture-recapture analysis for assessing the effectiveness of an integrated surveillance system

Invasive meningococcal disease in the Veneto region of Italy: a capture-recapture analysis for assessing the effectiveness of an integrated surveillance system

Virulence Traits of a Serogroup C Meningococcus and Isogenic cssA Mutant, Defective in Surface-Exposed Sialic Acid, in a Murine Model of Meningitis

Use of Information Sources on Vaccine-Preventable Diseases in Pregnant Women: An Experience in Ferrara, Italy

Contact Info

Product

Resources

About