Meningococcal serogroup Y disease in Europe: Continuation of high importance in some European regions in 2013

Bröker, Michael; Emonet, Stéphane; Fazio, Cecilia; Jacobsson, Susanne; Koliou, Maria; Kuusi, Markku; Pace, David; Paragi, Metka; Pysik, Alexander; Simões, Maria João; Skoczyńska, Anna; Stefanelli, Paola; Toropainen, Maija; Taha, Muhamed-Kheir; Tzanakaki, Georgina

doi:10.1080/21645515.2015.1051276

Cited by 64 publications

(49 citation statements)

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“…It is worth noting, that until recently, MenY was of minor importance among the invasive strains in Europe accounting for less than 2% of reported IMD cases mainly isolated among the elderly. However, an increase of MenY cases has been reported in various European countries since 2010 and a shift to younger age groups was also observed [24]. Similarly, an increase was observed in Greece from 2% (2013) and 3.5% (2014) to 8.1% for 2015 [16].…”

Section: Discussionmentioning

confidence: 95%

Meningococcal Carriage in Military Recruits and University Students during the Pre MenB Vaccination Era in Greece (2014-2015)

et al. 2016

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PurposeThe aim of the study was to estimate the meningococcal carriage rate and to identify the genotypic characteristics of the strains isolated from healthy military recruits and university students in order to provide data that might increase our understanding on the epidemiology of meningococcus and obtain information which helps to evaluate the potential effects on control programs such as vaccination.,MethodsA total of 1420 oropharyngeal single swab samples were collected from military recruits and university students on voluntary basis, aged 18–26 years. New York City Medium was used for culture and the suspected N. meningitidis colonies were identified by Gram stain, oxidase and rapid carbohydrate utilization tests. Further characterisation was carried out by molecular methods (multiplex PCR, MLST, WGS).ResultsThe overall carriage rate was of 12.7%; 15% and 10.4% for recruits and university students respectively. MenB (39.4%) was the most prevalent followed by MenY (12.8%) and MenW (4.4%). Among the initial 76 Non Groupable (NG) isolates, Whole Genome Sequence Analysis (WGS) revealed that 8.3% belonged to MenE, 3.3% to MenX and 1.1% to MenZ, while, 53 strains (29.4%) were finally identified as capsule null. Genetic diversity was found among the MenB isolates, with 41/44 cc and 35 cc predominating.ConclusionMeningococcal carriage rate in both groups was lower compared to our previous studies (25% and 18% respectively) with predominance of MenB isolates. These findings, help to further our understanding on the epidemiology of meningococcal disease in Greece. Although the prevalence of carriage seems to have declined compared to our earlier studies, the predominant MenB clonal complexes (including 41/44cc and 35cc) are associated with invasive meningococcal disease.

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Section: Discussionmentioning

confidence: 95%

Meningococcal Carriage in Military Recruits and University Students during the Pre MenB Vaccination Era in Greece (2014-2015)

et al. 2016

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“…5 Recent evidence indicates that meningococcal serogroup Y (MenY) has continued to increase in northern Europe and the proportion of IMD attributable to MenY remains high in Scandinavian countries, ranging from 26% to 51%. 6 An analysis of consolidated data (referring to 2014) shows that the incidence of IMD in Italy has remained stable in recent years, apart from an unexpected increase in the cases of MenC in young adults was reported in 2015 due to a cluster in Tuscany, which recurred in the early months of 2016. 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.…”

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

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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.

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“…In the EU area, serogroup B is the predominant cause of IMD, followed by serogroup C, whereas serogroup Y is recently increasing (Bröker et al, 2015;Törös et al, 2014). The only successful meningococcal disease prevention tool is represented by conjugate vaccines, including both meningococcal serogroup C glycoconjugate vaccines and quadrivalent conjugate vaccines against serogroups A, C, Y and W. Moreover, a novel meningococcal multicomponent vaccine, four-component meningococcal serogroup B (4CMenB; Bexsero ® ), has been approved in Europe, Canada, Australia and USA.…”

Section: Introductionmentioning

confidence: 99%

Molecular characterization of a collection of Neisseria meningitidis isolates from Croatia, June 2009 to January 2014

Bukovski¹,

Vacca

Anselmo³

et al. 2016

Journal of Medical Microbiology

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In the last decade, the incidence of invasive meningococcal disease (IMD) in Croatia remained stable at approximately 1 case per 100 000 inhabitants, affecting mainly children aged 5 years. We report the molecular characterization of meningococci causing IMD occurring from June 2009 to January 2014 in Croatia. Genomic DNA from 50 clinical isolates was analysed for serogroup, multilocus sequence typing and allele type of the two outer membrane protein genes, porA and the iron-regulated fetA. Furthermore, 22 of them were characterized by using whole-genome sequencing to define the meningococcal vaccine four-component meningococcal serogroup B (4CMenB) antigen genes factor H-binding protein (fHbp), Neisseria heparin-binding antigen (nhba) and Neisseria adhesin A (nadA) and the antimicrobial target resistance genes for penicillin (penicillin binding protein 2, penA), ciprofloxacin (DNA gyrase subunit A, gyrA) and rifampicin (b-subunit of RNA polymerase, rpoB). The Etest was used to phenotypically determine the antimicrobial susceptibility of isolated meningococci. The main serogroup/clonal complex combinations were MenB cc41/44, MenC/cc11, MenW/cc174 and MenY/cc23. PorA P1.7-2, FetA F5-5 and F1-5 were the most represented through the serogroups. Meningococci with decreased susceptibility to penicillin (38.9 %) and one strain resistant to ciprofloxacin were identified. Forty-two percent of MenB showed the presence of at least one of the 4CMenB vaccine antigens (fHbp, NHBA, NadA and PorA). Our findings highlight the genetic variability of meningococci causing IMD in Croatia, especially for the serogroup B. Molecular-based characterization of meningococci is crucial to enhance IMD surveillance and to better plan national immunization programmes. INTRODUCTIONInvasive meningococcal disease (IMD) is caused by Neisseria meningitidis, a strict human pathogen affecting mainly children 5 years of age, adolescents and young adults (Stephens, 2009). IMD is characterized by meningitis, sepsis and less commonly pneumonia, arthritis and pericarditis.According to the European Centre for Disease Prevention and Control (ECDC) data, the incidence of IMD reported in European Union (EU) and European Economic Area countries in 2012 was substantially low (ECDC, 2014), with an overall notification rate of 0.68 cases per 100 000 inhabitants. IMD case fatality ranged from 8 to 15 %, and approximately 10-20 % of survivors suffered from long-term sequelae including mental retardation, motor nerve deficit, hearing loss and loss of limbs (ECDC, 2014;Stephens, 2009). †These authors contributed equally to this work.

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Meningococcal serogroup Y disease in Europe: Continuation of high importance in some European regions in 2013

Cited by 64 publications

References 9 publications

Meningococcal Carriage in Military Recruits and University Students during the Pre MenB Vaccination Era in Greece (2014-2015)

Meningococcal Carriage in Military Recruits and University Students during the Pre MenB Vaccination Era in Greece (2014-2015)

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

Molecular characterization of a collection of Neisseria meningitidis isolates from Croatia, June 2009 to January 2014

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