Secular trends in invasive meningococcal disease, Massachusetts, 1988–2011: what happened to invasive disease?

2014 ◽  
Vol 142 (12) ◽  
pp. 2483-2490 ◽  
Author(s):  
A. H. PERUSKI ◽  
P. KLUDT ◽  
R. S. PATEL ◽  
A. DeMARIA
Keyword(s):  
Meningococcal Disease ◽  
Age Groups ◽  
Substantial Reduction ◽  
Invasive Disease ◽  
Secular Trends ◽  
Invasive Meningococcal Disease ◽  
Age Group ◽  
Meningococcal Vaccine ◽  
Average Annual Incidence ◽  
Potential Factors

SUMMARYInvasive meningococcal disease (IMD) reported to the Massachusetts Department of Public Health from 1988 to 2011 was reviewed. The average annual incidence of IMD/100 000 decreased from 1·57 [95% confidence interval (CI) 1·42–1·73] for 1988–1991 to 0·22 (95% CI 0·17–0·29) for 2008–2011. The pattern of decreasing incidence over time differed by age group. There was a decrease in IMD/100 000 in the 0–4 years age group after 1991 from 10·92 (95% CI 8·08–14·70) in 1991 to 5·76 (95% CI 3·78–8·72) in 1992. Incidence in the 0–4 years age group remained below 5/100 000 per year on average thereafter. A substantial reduction in incidence in all age groups was observed between 2000 and 2009, which began before the introduction of conjugate meningococcal vaccine in 2005. Marked reductions in incidence of IMD in Massachusetts, and elsewhere, deserve further investigation with respect to potential factors that go beyond the introduction and deployment of improved meningococcal vaccines.

scholarly journals Influence of Patient Age on Streptococcus pneumoniae Serotypes Causing Invasive Disease

2001 ◽  
Vol 8 (3) ◽  
pp. 556-559 ◽  
Author(s):  
Jaime Inostroza ◽  
Ana Maria Vinet ◽  
Gloria Retamal ◽  
Pedro Lorca ◽  
Gonzalo Ossa ◽  
...  
Keyword(s):  
Age Groups ◽  
Invasive Disease ◽  
Bacterial Virulence ◽  
Host Factors ◽  
Invasive Infection ◽  
Age Group ◽  
Southern Chile ◽  
Age Related ◽  
Sterile Site ◽  
Selection Of

ABSTRACT All clinical S. pneumoniae specimens isolated from patients with invasive or sterile-site infections admitted to one regional general hospital in southern Chile were collected during a 5-year period (February 1994 to September 1999). A total of 247 strains belonging to 50 serotypes were isolated in this survey: 69 in patients under 5 years of age, 129 in patients 5 to 64 years old, and 49 from patients 65 years and older. Eight serotypes were identified in all age groups, while all other serotypes were found exclusively in one age group or in patients over 4 years of age. Serotype 3 was never found in patients under 5 years old, and serotype 14 was not found in patients >64 years of age. There was no difference in the serotypes causing infection in each one of the 5 years of the survey. Our results suggest that both bacterial virulence factors and host factors play an important role in the selection of S. pneumoniae serotypes causing invasive infection. Possible host factors include age-related differences in the immune response. Comparative studies with other areas of the world may help to further understanding of our observations in southern Chile.

scholarly journals Secular trends in emergency department encounters for concussion at US children's hospitals by age group (2008–2017)

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S22.2-S22
Author(s):  
Amy Linabery ◽  
Kara Seaton ◽  
Alicia Zagel ◽  
Alicen Spaulding ◽  
Gretchen Cutler ◽  
...  
Keyword(s):  
Emergency Department ◽  
Public Awareness ◽  
Weighted Least Squares ◽  
Age Groups ◽  
Secular Trends ◽  
Medical Attention ◽  
Age Group ◽  
Admission Rates ◽  
Pediatric Hospitals ◽  
Over Time

BackgroundIncreased concussion rates in US youth have been documented since 2000. Concomitant rises in healthcare utilization for concussion are likely attributable to public health, media, and legislative initiatives aimed at increasing public awareness of the importance of seeking medical attention after injury. Utilization trends in young children have not been well-documented, however.ObjectiveTo characterize recent secular trends in pediatric emergency department (ED) encounters for concussion by 4-year age group.MethodsUsing Children's Hospital Association's Pediatric Health Information System data, we examined a retrospective cohort of patients aged 2–17 years with an ED encounter for concussion at 22 US pediatric hospitals with continuous data between 2008 and 2017. Average annual change in rates of ED visits for concussion and sports-/recreation-related concussion, imaging, and admissions were estimated via weighted least-squares regression.ResultsED encounters with a primary indication of concussion comprised 0.8% (n = 86,393) of all ED encounters in 2008–2017. Over time, ED concussion visits in 6–17-year-olds increased by 0.5–1.1 per 1,000 ED encounters per year (all Ptrend< 0.0001), while rates among 2-5-year-olds remained stable (Ptrend = 0.72). Rates for sports-/recreation-related concussions increased significantly across all age groups (<0.0001 ≤ Ptrend ≤ 0.01). Absolute number undergoing any imaging increased in all age groups; however, due to increased ED concussion encounters, the rate of imaging decreased overall (−29.7/1,000 ED concussion encounters/year; Ptrend < 0.0001) and across all age groups; the imaging rate decreased less for 2-5-year-olds (−19.6/1,000 encounters/year; Ptrend < 0.0001). Likewise, admission rates declined significantly over time overall (−10.1/1,000 encounters/y; Ptrend = 0.0006) and for all age groups.ConclusionsED concussion encounter rates in US youth aged 6–17 years continue to increase at pediatric hospitals, suggesting awareness efforts have been effective. Conversely, imaging and admission rates have decreased, indicating efforts to curtail unnecessary irradiation and intervention have also been successful. Trends in 2-5-year-olds were somewhat different from older youth and should be explored further.

Genomic Characterization of Recent and Historic Meningococcal Serogroup E Invasive Disease in Australia: A Case Series

2019 ◽  
Vol 70 (8) ◽  
pp. 1761-1763 ◽  
Author(s):  
Dharshi Thangarajah ◽  
Christine J D Guglielmino ◽  
Stephen B Lambert ◽  
Gulam Khandaker ◽  
Bhakti R Vasant ◽  
...  
Keyword(s):  
Meningococcal Disease ◽  
Molecular Typing ◽  
Case Series ◽  
Invasive Disease ◽  
Invasive Meningococcal Disease ◽  
Recent Emergence ◽  
Genomic Characterization

Abstract We report the recent emergence of invasive meningococcal disease due to serogroup E in Queensland, Australia, in previously healthy patients. Molecular typing revealed the genotype of these strains to be E:P1.21-7,16:F5-36:ST-1157 (cc1157); when analyzed phylogenetically, compared with international cc1157 strains, they were relatively unrelated to each other.

scholarly journals Sustained reduction in the carriage of Neisseria meningitidis as a result of a community meningococcal disease control programme

1998 ◽  
Vol 121 (3) ◽  
pp. 487-493 ◽  
Author(s):  
K. R. NEAL ◽  
D. J. IRWIN ◽  
S. DAVIES ◽  
E. B. KACZMARSKI ◽  
M. C. J. WALE
Keyword(s):  
Neisseria Meningitidis ◽  
Meningococcal Disease ◽  
Community Intervention ◽  
Economic Status ◽  
Age Groups ◽  
Control Programme ◽  
Age Group ◽  
Intervention Programme ◽  
Intervention Area ◽  
Sustained Reduction

The effect of a community intervention programme of antibiotics and meningitis vaccine on pharyngeal carriage of Neisseria meningitidis was investigated. Carriage rates were determined in pupils at both secondary schools (ages 11–18 years) included in the community intervention programme and compared with two schools outside the area matched for socio-economic status. A total of 1869 pupils were studied 6 months after the programmes, and 2457 pupils after 11 months.Six months after the programme was completed there was a 72% reduction in pharyngeal carriage of Neisseria meningitidis in pupils attending the schools in the intervention area compared with pupils in the control schools. After 11 months this difference persisted in the 11–14 age group but not in the 15–18 age group. No resistance to the antibiotics used in the programme was found.A community intervention programme of antibiotics and vaccine for the control of meningococcal disease led to a long-term reduction in Neisseria meningitidis carriage in some age groups.

scholarly journals Community outbreak of serogroup B invasive meningococcal disease in Beaujolais, France, February to June 2016: from alert to targeted vaccination

2018 ◽  
Vol 23 (28) ◽  
Author(s):  
Alexandra Thabuis ◽  
Karim Tararbit ◽  
Muhamed-Kheir Taha ◽  
Dominique Dejour-Salamanca ◽  
Vincent Ronin ◽  
...  
Keyword(s):  
Meningococcal Disease ◽  
Clonal Complex ◽  
Vaccination Campaign ◽  
Age Groups ◽  
Invasive Meningococcal Disease ◽  
Epidemic Threshold ◽  
Epidemic Area ◽  
Area North ◽  
Meningococcal Strain ◽  
Microbiological Surveillance

In February and March 2016, four cases of serogroup B invasive meningococcal disease (IMD) occurred over 3 weeks in a small area north of Lyon in the Auvergne-Rhône-Alpes region, France. There were no deaths but two cases had sequelae. This community outbreak was caused by a rare meningococcal strain of the clonal complex ST-32, covered by the 4CMenB/Bexsero vaccine. The incidence rate for serogroup B IMD in this area was 22.5 per 100,000 inhabitants, which is above the epidemic threshold (10/100,000). The number of cases observed was significantly higher than expected in the age group of 0–24 year-olds (standardised incidence ratio: 96). These results suggested the potential emergence of this invasive strain in this sub-population. In accordance with French recommendations, it was decided to vaccinate the population aged between 2 months and 24 years, living, working or studying in the epidemic area. The vaccination campaign took place from April to September 2016. Vaccination coverage was estimated at 47% for one dose and 40% for two doses. The lowest coverage estimations were observed for the age groups younger than 3 and 15–19 years. Enhanced epidemiological and microbiological surveillance reported a fifth case in June 2016, outside the epidemic area.

scholarly journals Surveillance of invasive meningococcal disease in the Czech Republic

2004 ◽  
Vol 9 (11) ◽  
pp. 11-12 ◽  
Author(s):  
P Kriz
Keyword(s):  
Czech Republic ◽  
Neisseria Meningitidis ◽  
Meningococcal Disease ◽  
Western Europe ◽  
Vaccination Strategy ◽  
Invasive Disease ◽  
Invasive Meningococcal Disease ◽  
Mortality Data ◽  
Meningococcal Infections ◽  
The Czech Republic

Routine notification of invasive meningococcal disease has a long tradition in the Czech Republic: mortality data are available from 1921 and morbidity data from 1943. The collection of Neisseria meningitidis strains kept in the NRL for Meningococcal Infections in Prague dates from 1970 onwards, and represents more than 3500 strains isolated from invasive disease and their contacts, from healthy carriers and from respiratory infection. Analysis of these strains showed that the Czech meningococcal population is different from that seen in western Europe. In 1993, the incidence serogroup C meningococcal disease increased and was associated with the emergence of the hypervirulent complex Neisseria meningitidis C, ST-11, ET-15/37, and caused an increase in the incidence of invasive meningococcal disease which peaked in 1995 (2.2/100 000). A vaccination strategy targeting the part of the population at highest risk of invasive meningococcal disease was adopted in the country.

scholarly journals Estimation of the real burden of invasive meningococcal disease in Argentina

2019 ◽  
Vol 147 ◽  
Author(s):  
J. A. Gómez ◽  
P. Wetzler Malbrán ◽  
G. Vidal ◽  
M. Seoane ◽  
N. D. Giglio
Keyword(s):  
Meningococcal Disease ◽  
Age Groups ◽  
Invasive Meningococcal Disease ◽  
Detection Methods ◽  
Health Concern ◽  
Surveillance Systems ◽  
Significant Public Health ◽  
The One ◽  
Definition Of ◽  
Reported Data

Abstract Among the different existing types of bacterial meningitis, the one caused by Neisseria meningitidis is the main presentation of invasive meningococcal disease (IMD). IMD is a significant public health concern and has a reported incidence rate in Argentina of 0.44 cases per 100 000 inhabitants in 2015. However, the actual incidence is thought to be higher as passive surveillance systems neither report nor identify 100% of all cases. The aim of this study is to develop an estimation of the burden of IMD in Argentina closer to reality by adjusting/correcting several limitations observed in the surveillance data available. A retrospective observational study has been performed using four Argentinean national databases recording the number of IMD cases and deaths, serogroups of N. meningitidis and ages, between 2007 to 2016. The reported data were adjusted to account for underreporting and to also integrate the cases missed due to well-known limitations associated with the diagnosis of N. meningitidis detection methods. Data were further analysed by serogroups of N. meningitidis and by age groups. After these adjustments, the potential numbers of IMD cases and IMD-related deaths are estimated to be 3.1 and 1.9 higher than reported, respectively. The study corrects the previous underestimation of the disease burden and provides expectedly more robust estimates aligned with international evidence and highlights the importance of active surveillance, with high-quality methods, for a better definition of preventive strategies against IMD in Argentina.

scholarly journals Invasive Meningococcal Disease due to Nongroupable Neisseria meningitidis—Active Bacterial Core Surveillance Sites, 2011–2016

2019 ◽  
Vol 6 (5) ◽  
Author(s):  
Lucy A McNamara ◽  
Caelin C Potts ◽  
Amy Blain ◽  
Nadav Topaz ◽  
Mirasol Apostol ◽  
...  
Keyword(s):  
Neisseria Meningitidis ◽  
Meningococcal Disease ◽  
Invasive Disease ◽  
Invasive Meningococcal Disease ◽  
Complement Deficiency

Abstract We characterized 22 meningococcal disease cases due to nongroupable Neisseria meningitidis, a rare cause of invasive disease. Disease presentation and severity were similar to those for serogroupable meningococcal disease. However, 7 (32%) patients had complement deficiency or abnormal complement testing results, highlighting the importance of complement testing for nongroupable cases.

Changing epidemiology of invasive meningococcal disease in Australia 1994–2016

2017 ◽  
Vol 38 (4) ◽  
pp. 184
Author(s):  
Helen V Smith ◽  
Amy V Jennison
Keyword(s):  
Meningococcal Disease ◽  
Age Groups ◽  
Case Fatality ◽  
Antimicrobial Treatment ◽  
Invasive Meningococcal Disease ◽  
Public Health Issue ◽  
Vaccination Programs ◽  
Invasive Infections ◽  
Low Incidence

Invasive meningococcal disease (IMD) has a relatively low incidence in Australia, however remains a serious public health issue, with a case fatality rate of approximately 10% despite antimicrobial treatment. IMD is particularly seen in young children, but can affect all age groups. The disease has non-specific early symptoms, rapid clinical progression mainly manifesting as septicaemia and/or meningitis, and has the potential for long term sequelae in the survivors, including skin scarring, amputation, deafness and seizures. There are 13 serogroups, although most invasive infections worldwide are caused by serogroups A, B, C, W, and Y, with some recent outbreaks in Africa caused by serogroup X. The prevalent circulating serogroups can undergo dynamic shifts, generating dramatic changes in IMD epidemiology. Such serogroup shifts have important ramifications for vaccination programs and constant surveillance is crucial.

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