scholarly journals 1429. Meningococcal Disease Outbreak in a Refugee Reception Identification Center in Greece and Administration of Mass Antibiotic Prophylaxis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S720-S721
Author(s):  
Ioanna Magaziotou ◽  
Sotirios Tsiodras ◽  
Athanasia Xirogianni ◽  
Maria Tseroni ◽  
Katerina Syrigonaki ◽  
...  
Keyword(s):  
Public Health ◽  
Antibiotic Prophylaxis ◽  
Meningococcal Disease ◽  
Molecular Typing ◽  
Health Management ◽  
Laboratory Data ◽  
Reference Laboratory ◽  
Refugee Camps ◽  
Directly Observed Therapy ◽  
Public Health Organization

Abstract Background An increased likelihood of transmission of communicable diseases such as invasive meningococcal disease (IMD) exists in refugee camps. Herein, we describe an outbreak investigation of 5 IMD cases among immigrants in Greece. Methods Epidemiological, clinical and laboratory data (culture and molecular identification) as well as the public health management concerning an outbreak of meningococcal disease in a refugee Reception Identification Center (RIC), are described. Results During the period 17th January - 17th February 2020, five cases of IMD in refugees were reported to the National Public Health Organization (NPHO). Four cases were from Afghanistan and resided in the RIC of Lesvos Island; two females aged 2 yo and 21 yo and two males 13 yo and 6 yo. The fifth case, a 4 month old male of Syrian nationality, exhibited symptoms after moving to an inland accommodation center (AC) from Lesvos RIC, on December 2019. Four of the cases presented with meningitis and septicaemia. All cases recovered and had no common exposure other than shared geographic space. Neisseria meningitidis was identified by molecular typing (mPCR, PorA, MLST, WGS) in all cases at the National Meningitis Reference Laboratory; 3/5 cases were identified as MenB, porA 7-2,4, and ST-3129 (new clone) while 2/5 (21 yo female, 13 yo male) as MenY, porA: 5.2, ST-22cc. To prevent secondary cases, antimicrobial chemoprophylaxis via Directly Observed Therapy (DOT) was administered to 4.024 Afgan close contacts (26.7% of the total Afgan population). MenACWY and MenB vaccination was recommended in response to outbreak among persons aged < 20 years old. No new IMD case occurred in the RIC during a follow-up period of 4 months. Conclusion The detection of a new clone in Greece of Chinese and Taiwanese origin through migrants, further underlines the need of enhanced surveillance for early detection, molecular typing, immediate intervention with antibiotic prophylaxis and/or supplemental vaccination in order to prevent IMD in refugee camps. Disclosures All Authors: No reported disclosures

scholarly journals Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016

2019 ◽  
Author(s):  
Diederik A.H. Brandwagt ◽  
Arie van der Ende ◽  
Helma (W.) L.M. Ruijs ◽  
Hester E. de Melker ◽  
Mirjam J. Knol
Keyword(s):  
Public Health ◽  
The Netherlands ◽  
Meningococcal Disease ◽  
Surveillance System ◽  
National Level ◽  
Vaccination Status ◽  
Invasive Meningococcal Disease ◽  
Reference Laboratory ◽  
Public Health Response ◽  
Notification Data

Abstract Background Enhanced surveillance for confirmed cases of invasive meningococcal disease (IMD) was introduced in the Netherlands in 2003, in which reference laboratory data (NRLBM) are linked with notification data (OSIRIS). The quality of surveillance information is important for public health decision making. Our objective was to describe the system and evaluate it for data completeness and timeliness.
Methods
Cases reported in the surveillance system from 2004 to 2016 were included. For the notification data, we used information on serogroup, vaccination status, mortality, and country of infection as indicators for record completeness. Notification times to regional and national level were calculated using the reported dates available in the notification database. 
Results
A total of 2,123 cases were reported in the years 2004-2016, of which 1.968 (93%) were reported by the reference laboratory and 1.995 (94%) in the notification system. Of all cases, 1.840 cases (87%) were reported in both systems and could be linked. The serogroup was known in 86% of the notified cases, and was significantly higher (94%) in the years 2013-2016. Information on vaccination status, mortality and country of infection was available in 88%, 99% and 97% of notified cases, respectively. Regional notification of cases occurred within one working day for 86% of cases and 98% were notified nationally within three days. 
Conclusions
A well performing IMD surveillance system was demonstrated and serogroup completeness has improved over the years. Underlining the need for reporting to both the clinical and laboratory surveillance system remains important to further improve the overall performance in supporting public health response and vaccination policy.

scholarly journals Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Germaine Hanquet ◽  
Pawel Stefanoff ◽  
Wiebke Hellenbrand ◽  
Sigrid Heuberger ◽  
Pierluigi Lopalco ◽  
...  
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Meningococcal Disease ◽  
Public Health Policy ◽  
Health Management ◽  
Lessons Learned ◽  
Quality Of Evidence ◽  
Research Questions ◽  
Grade Methodology

The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low.

scholarly journals Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016

2019 ◽  
Author(s):  
Diederik A.H. Brandwagt ◽  
Arie van der Ende ◽  
Helma (W.) L.M. Ruijs ◽  
Hester E. de Melker ◽  
Mirjam J. Knol
Keyword(s):  
Public Health ◽  
The Netherlands ◽  
Meningococcal Disease ◽  
Surveillance System ◽  
National Level ◽  
Vaccination Status ◽  
Invasive Meningococcal Disease ◽  
Reference Laboratory ◽  
Public Health Response ◽  
Notification Data

Abstract Background Enhanced surveillance for confirmed cases of invasive meningococcal disease (IMD) was introduced in the Netherlands in 2003, in which reference laboratory data (NRLBM) are linked with notification data (OSIRIS). The quality of surveillance information is important for public health decision making. Our objective was to describe the system and evaluate it for data completeness and timeliness.
Methods
Cases reported in the surveillance system from 2004 to 2016 were included. For the notification data, we used information on serogroup, vaccination status, mortality, and country of infection as indicators for record completeness. Notification times to regional and national level were calculated using the reported dates available in the notification database. 
Results
A total of 2,123 cases were reported in the years 2004-2016, of which 1.968 (93%) were reported by the reference laboratory and 1.995 (94%) in the notification system. Of all cases, 1.840 cases (87%) were reported in both systems and could be linked. The serogroup was known in 86% of the notified cases, and was significantly higher (94%) in the years 2013-2016. Information on vaccination status, mortality and country of infection was available in 88%, 99% and 97% of notified cases, respectively. Regional notification of cases occurred within one working day for 86% of cases and 98% were notified nationally within three days. 
Conclusions
A well performing IMD surveillance system was demonstrated and serogroup completeness has improved over the years. Underlining the need for reporting to both the clinical and laboratory surveillance system remains important to further improve the overall performance in supporting public health response and vaccination policy.

scholarly journals Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016

2019 ◽  
Author(s):  
Diederik A.H. Brandwagt ◽  
Arie van der Ende ◽  
Helma (W.) L.M. Ruijs ◽  
Hester E. de Melker ◽  
Mirjam J. Knol
Keyword(s):  
Public Health ◽  
The Netherlands ◽  
Meningococcal Disease ◽  
Surveillance System ◽  
National Level ◽  
Vaccination Status ◽  
Invasive Meningococcal Disease ◽  
Reference Laboratory ◽  
Public Health Response ◽  
Notification Data

Abstract Background Enhanced surveillance for confirmed cases of invasive meningococcal disease (IMD) was introduced in the Netherlands in 2003, in which reference laboratory data (NRLBM) are linked with notification data (OSIRIS). The quality of surveillance information is important for public health decision making. Our objective was to describe the system and evaluate it for data completeness and timeliness.
Methods
Cases reported in the surveillance system from 2004 to 2016 were included. For the notification data, we used information on serogroup, vaccination status, mortality, and country of infection as indicators for record completeness. Notification times to regional and national level were calculated using the reported dates available in the notification database. 
Results
A total of 2,123 cases were reported in the years 2004-2016, of which 1.968 (93%) were reported by the reference laboratory and 1.995 (94%) in the notification system. Of all cases, 1.840 cases (87%) were reported in both systems and could be linked. The serogroup was known in 86% of the notified cases, and was significantly higher (94%) in the years 2013-2016. Information on vaccination status, mortality and country of infection was available in 88%, 99% and 97% of notified cases, respectively. Regional notification of cases occurred within one working day for 86% of cases and 98% were notified nationally within three days. 
Conclusions
A well performing IMD surveillance system was demonstrated and serogroup completeness has improved over the years. Underlining the need for reporting to both the clinical and laboratory surveillance system remains important to further improve the overall performance in supporting public health response and vaccination policy.

scholarly journals Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013

2016 ◽  
Vol 21 (24) ◽  
Author(s):  
Jane Bethea ◽  
Sophia Makki ◽  
Steve Gray ◽  
Vanessa MacGregor ◽  
Shamez Ladhani
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Clinical Presentation ◽  
Health Management ◽  
Geographical Location ◽  
East Midlands ◽  
Shared Space ◽  
Large Outbreak ◽  
Local Transmission

In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts.

Meningococcal disease in Wales: Clinical features, outcome and public health management

1992 ◽  
Vol 25 (3) ◽  
pp. 321-328 ◽  
Author(s):  
S.R. Palmer ◽  
J. Corson ◽  
R. Hall ◽  
S. Payne ◽  
J. Ludlow ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Features ◽  
Meningococcal Disease ◽  
Health Management ◽  
Public Health Management
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