Changing epidemiology of Infant Meningococcal Disease after the introduction of meningococcal serogroup C vaccine in Italy, 2006–2014

Stefanelli, Paola; Fazio, Cecilia; Neri, Arianna; Boros, Stefano; Renna, Giovanna; Pompa, Maria Grazia

doi:10.1016/j.vaccine.2015.06.032

Cited by 13 publications

(9 citation statements)

References 19 publications

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“…Serogroup B was responsible for the majority of IMD cases in all age groups, with a statistically significant higher incidence compared to any other serogroup. As already reported in Italy, serogroup B is the predominant among infants [ 15 ]. The Bexsero has been recently introduced in Italy even if with differences among the Regions.…”

Section: Discussionmentioning

confidence: 58%

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Epidemiological and Molecular Characterization of Invasive Meningococcal Disease in Italy, 2008/09-2012/13

et al. 2015

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BackgroundFollowing the introduction of meningococcal serogroup C conjugate vaccine in Italy in 2005, changes in the epidemiology of Invasive Meningococcal Disease (IMD) were expected. The study aims were to describe the epidemiological trend and to characterize the isolates collected during the period 2008/09-2012/13 by multilocus sequence typing (MLST). Data on laboratory confirmed meningococcal diseases from National Surveillance System of IMD were reported.MethodsPoisson regression models were used to estimate the incidence rate over time. Serogrouping and MLST were performed following published methods.ResultsThe incidence rate of laboratory confirmed meningococcal disease decreased from 0.33 per 100,000 population in 2008/09 to 0.25 per 100,000 population in 2012/13. The serogroup B incidence rate was significantly higher (p<0.01) than that of other serogroups, among all age groups. The significant decrease of the IMD incidence rate (p = 0.01) reflects the decrease of serogroup B and C, in particular among individuals aged 15–24 years old (p<0.01). On the other hand, serogroup Y incidence increased during the period (from 0.01/100,000 in 2008/09 to 0.02/100,000 in 2012/13, p = 0.05). Molecular characterizations revealed that ST–41/44 cc and ST–11 cc were the main clonal complexes identified among serogroup B and C isolates, respectively. In particular, ST–41/44 cc was predominant in all age groups, whereas ST–11 cc was not identified in infants less than 1 year of age.ConclusionsIMD incidence declined in Italy and serogroup B caused most of the IMD cases, with infants having the highest risk of disease. Continued surveillance is needed to provide information concerning further changes in circulating meningococci with special regard to serogroup distribution. Moreover, knowledge of meningococcal genotypes is essential to detect hyper-invasive strains.

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Section: Discussionmentioning

confidence: 58%

“…In Italy, in a previous analysis IMD due to serogroup C meningococci affected mostly children less than 4 years of age and adolescents, [ 14 ], but now the serogroup B is highly predominant, [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Epidemiological and Molecular Characterization of Invasive Meningococcal Disease in Italy, 2008/09-2012/13

et al. 2015

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“…19 Based on the data in the national integrated surveillance systems (MNS and NSS) and the LSS, the incidence of IMD was estimated at 0.39/100 000 for the years 2007-2014. Linkage between these sources returned a higher rate than the one estimated for Italy in recent years (0.28/100 000), 20 and for infants <1 year old it was 5.4/100 000, as opposed to the estimated 3.6/100 000. This discrepancy is probably attributable partly to the endemic epidemiological profile of the distribution of N. meningitidis in the geographical area considered in this study, but also to a different sensitivity of the surveillance systems in recording the total number of cases of IMD, which makes it difficult to reliably establish the burden of these diseases.…”

Section: Discussionmentioning

confidence: 60%

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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“…An invasive meningococcal disease (IMD)is a severe and a life-threatening disease caused by various Neisseria meningitidis serogroups, and it represents a serious public health problem worldwide, with an annual number of cases estimated to be at least 1.2 million [ 1-3 ]. In Europe, the USA and other industrialized regions, serogroups B and C are the major causes of IMDs [ 4 , 5 ]. Approximately one in ten cases are fatal, and among those who survive, long-term sequelae, such as hearing loss, neurological defects or amputation, can occur [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Do HCWs adequately know about meningitis and 4CmenB vaccine and recommend its use to parents? A cross sectional analysis in Campania Region, Italy

Ponticelli

D’Ambrosio

Cancellieri

et al. 2019

Journal of Preventive Medicine and Hygiene

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Changing epidemiology of Infant Meningococcal Disease after the introduction of meningococcal serogroup C vaccine in Italy, 2006–2014

Cited by 13 publications

References 19 publications

Epidemiological and Molecular Characterization of Invasive Meningococcal Disease in Italy, 2008/09-2012/13

Epidemiological and Molecular Characterization of Invasive Meningococcal Disease in Italy, 2008/09-2012/13

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

Do HCWs adequately know about meningitis and 4CmenB vaccine and recommend its use to parents? A cross sectional analysis in Campania Region, Italy

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