Characterisation of carried and invasive Neisseria meningitidis isolates in Shanghai, China from 1950 to 2016: implications for serogroup B vaccine implementation

AbstractBackgroundSerogroup B invasive meningococcal disease (IMD) is increasing in China, little is known however, about these meningococci. This study characterises a collection of isolates associated with IMD and carriage in Shanghai and assesses current vaccine strategies.MethodsIMD epidemiological data in Shanghai from 1950–2016 were obtained from the National Notifiable Diseases Registry System, with 460 isolates collected for analysis including, 169 from IMD and 291 from carriage. Serogroup B meningococcal (MenB) vaccine coverage was evaluated using Bexsero® Antigen Sequence Type (BAST).ResultsSeven IMD epidemic periods have been observed in Shanghai since 1950, with incidence peaking from February to April. Analyses were divided according to the period of meningococcal polysaccharide vaccine (MPV) introduction: (i) pre-MPV-A, 1965-1980; (ii) post-MPV-A, 1981-2008; and (iii) post-MPV-A+C, 2009-2016. IMD incidence decreased from 55.4/100,000 to 0.71 then to 0.02, and corresponded with shifts from serogroup A ST-5 complex (MenA:cc5) to MenC:cc4821 then MenB:cc4821. MenB IMD became predominant (63.2%) in the post-MPV-A+C period, of which 50% were caused by cc4821, with the highest incidence in infants (0.45/100,000) and a case-fatality rate of 9.5%. IMD was positively correlated with carriage rates. Data indicate that fewer than 25% of MenB isolates in the post-MPV-A+C period may be covered by the vaccines Bexsero®, Trumenba®, or a PorA-based vaccine, NonaMen.ConclusionsA unique IMD epidemiology is found in China, changing periodically from hyperepidemic to low-level endemic disease. MenB IMD now dominates in Shanghai, with isolates harbouring diverse antigenic variants potentially beyond coverage with licenced OMV- and protein-based MenB vaccines.SummaryMeningococcal disease in Shanghai, China is described and current vaccine approaches evaluated. Since 1950, MenA:cc5 shifted to MenC:cc4821 then MenB:cc4821, with MenB dominating since 2009. Distinct antigens potentially beyond coverage with licensed OMV- and protein-based MenB vaccines were found.

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Variations in case fatality and fatality risk factors of meningococcal disease in Western Norway, 1985–2002

Epidemiology and Infection ◽

10.1017/s0950268805004553 ◽

2005 ◽

Vol 134 (1) ◽

pp. 103-110 ◽

Cited By ~ 10

Author(s):

I. SMITH ◽

A. T. BJØRNEVIK ◽

I. M. B. AUGLAND ◽

A. BERSTAD ◽

T. WENTZEL-LARSEN ◽

...

Keyword(s):

Risk Factors ◽

Skin Rash ◽

Meningococcal Disease ◽

Case Fatality Rate ◽

Multivariate Analyses ◽

Case Fatality ◽

Fatality Rate ◽

The Public ◽

Admission Time ◽

Meningococcal Septicaemia

SUMMARYIn a retrospective epidemiological study, 293 meningococcal disease patients hospitalized during 1985–2002, were examined for fatality and risk factors related to death. The overall case fatality rate (CFR) was 8·2%, but increased from 4% during 1985–1993 to 17% during 1994–2002. The latter 9-year period was characterized by more serogroup C infections and more patients with thrombocytopenia on admission to hospital. All patients categorized as meningitis on admission survived. Of the 24 patients who died, 21 had meningococcal skin rash on admission, 23 had an onset to admission time of ⩽24 h, and 16 had severe septicaemia with hypotension and/or ecchymoses without meningitis on admission. By multivariate analyses, a short onset to admission time, >50 petechiae, thrombocytopenia and severe septicaemia on admission were associated with fatality. More lives could be saved through earlier admission to hospital. This can be achieved through more information to the public about the early signs of meningococcal septicaemia, with the recommendation to look for skin rash in patients with acute fever during the first day and night.

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Invasive meningococcal disease associated with a very high case fatality rate in the North-West of Poland

FEMS Immunology & Medical Microbiology ◽

10.1111/j.1574-695x.2005.00027.x ◽

2006 ◽

Vol 46 (2) ◽

pp. 230-235 ◽

Cited By ~ 5

Author(s):

Anna SkoczyÅ„ska ◽

Marcin KadÅ‚ubowski ◽

JÃ³zef Knap ◽

Maria Szulc ◽

Marzena Janusz-Jurczyk ◽

...

Keyword(s):

Meningococcal Disease ◽

Case Fatality Rate ◽

Case Fatality ◽

Invasive Meningococcal Disease ◽

Fatality Rate ◽

High Case Fatality Rate ◽

North West ◽

The North ◽

Very High

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Is there room for improving case management for contacts of meningococcal disease in the European Union?

Eurosurveillance ◽

10.2807/ese.13.10.08057-en ◽

2008 ◽

Vol 13 (10) ◽

pp. 1-2 ◽

Cited By ~ 1

Author(s):

P L Lopalco

Keyword(s):

European Union ◽

Meningococcal Disease ◽

Case Fatality Rate ◽

Case Fatality ◽

Severe Illness ◽

Fatality Rate ◽

The European Union ◽

High Case Fatality Rate ◽

Children And Young Adults ◽

Loss Of Limbs

Invasive meningococcal disease (IMD) is a severe illness primarily affecting children and young adults. It has a high case fatality rate (10%-14%) and 11%-19% of patients who recover experience permanent hearing loss, mental retardation, loss of limbs or other serious sequelae.

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Global Epidemiology of First 90 Days into COVID-19 Pandemic: Disease Incidence, Prevalence, Case Fatality Rate and Their Association with Population Density, Urbanisation and Elderly Population

Journal of Health Management ◽

10.1177/0972063420932762 ◽

2020 ◽

Vol 22 (2) ◽

pp. 117-128 ◽

Cited By ~ 1

Author(s):

Shivam Gupta ◽

Kamalesh Kumar Patel ◽

Shobana Sivaraman ◽

Abha Mangal

Keyword(s):

Population Density ◽

Case Fatality Rate ◽

Elderly Population ◽

Disease Incidence ◽

Case Fatality ◽

Population Level ◽

Epidemiological Data ◽

Fatality Rate ◽

Global Epidemiology ◽

First 90 Days

As the COVID-19 pandemic marches exponentially, epidemiological data is of high importance to analyse the current situation and guide intervention strategies. This study analyses the epidemiological data of COVID-19 from 17 countries, representing 85 per cent of the total cases within first 90 days of lockdown in Wuhan, China. It follows a population-level observational study design and includes countries with 20,000 cases (or higher) as of 21 April 2020. We sourced the data for these 17 countries from worldometers. info, a digital platform being used by several media and reputed academic institutions worldwide. We calculated the prevalence, incidence, case fatality rate and trends in the epidemiology of COVID-19, and its correlation with population density, urbanisation and elderly population. The analysis represents 85 per cent ( N = 2,183,661) of all cases within the first 90 days of the pandemic. Across the analysed period, the burden of the pandemic primarily focused on high- and middle-income countries of Asia, Europe and North America. While the total number of cases and deaths are highest in USA, the prevalence, incidence and case fatality rates are higher in the European countries. The prevalence and incidence vary widely among countries included in the analysis, and the number of cases per million and the case fatality rate are correlated with the proportion of the elderly population and to a lesser extent with the proportion of the urban population.

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Morbidity, mortality and spatial distribution of meningococcal disease, 1974–2007

Epidemiology and Infection ◽

10.1017/s0950268809002428 ◽

2009 ◽

Vol 137 (11) ◽

pp. 1631-1640 ◽

Cited By ~ 17

Author(s):

M. HOWITZ ◽

L. LAMBERTSEN ◽

J. B. SIMONSEN ◽

J. J. CHRISTENSEN ◽

K. MØLBAK

Keyword(s):

Risk Factors ◽

Spatial Distribution ◽

Meningococcal Disease ◽

Case Fatality Rate ◽

Case Fatality ◽

Incidence Rates ◽

Fatality Rate ◽

Risk Of Death ◽

Increased Risk ◽

High Age

SUMMARYTo identify determinants for mortality and sequelae and to analyse the spatial distribution of meningococcal disease, we linked four national Danish registries. In the period 1974–2007, 5924 cases of meningococcal disease were registered. Our analysis confirms known risk factors for a fatal meningococcal disease outcome, i.e. septicaemia and high age (>50 years). The overall case-fatality rate was 7·6%; two phenotypes were found to be associated with increased risk of death; C:2a:P1.2,5 and B:15:P1.7,16. B:15:P1.7,16 was also associated with excess risk of perceptive hearing loss. The incidence rates of meningococcal disease were comparable between densely and less densely populated areas, but patients living further from a hospital were at significantly higher risk of dying from the infection. To improve control of meningococcal disease, it is important to understand the epidemiology and pathogenicity of virulent ‘successful clones’, such as C:2a:P1.2,5 and B:15:P1.7,16, and, eventually, to develop vaccines against serogroup B.

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Infection pattern, case fatality rate and spread of Lassa virus in Nigeria

BMC Infectious Diseases ◽

10.1186/s12879-021-05837-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Clement Ameh Yaro ◽

Ezekiel Kogi ◽

Kenneth Nnamdi Opara ◽

Gaber El-Saber Batiha ◽

Roua S. Baty ◽

...

Keyword(s):

Case Fatality Rate ◽

Control Strategies ◽

Case Fatality ◽

Epidemiological Data ◽

Integrated Approach ◽

Lassa Fever ◽

Lassa Virus ◽

Fatality Rate ◽

Wet Season ◽

Infection Pattern

Abstract Background Lassa fever (LF) is a zoonotic infectious disease of public concern in Nigeria. The infection dynamics of the disease is not well elucidated in Nigeria. This study was carried out to describe the pattern of infection, case fatality rate and spread of lassa virus (LASV) from 2017 to 2020. Methods Weekly epidemiological data on LF from December, 2016 to September, 2020 were obtained from Nigeria Centre for Disease Control. The number of confirmed cases and deaths were computed according to months and states. Descriptive statistics was performed and case fatality rate was calculated. Distribution and spread maps of LF over the four years period was performed on ArcMap 10.7. Results A total of 2787 confirmed cases and 516 deaths were reported in Nigeria from December, 2016 to September, 2020. Increase in number of cases and deaths were observed with 298, 528, 796 and 1165 confirmed cases and 79, 125, 158 and 158 deaths in 2017, 2018, 2019 and 2020 respectively. Over 60% of the cases were reported in two states, Edo and Ondo states. The LF cases spread from 19 states in 2017 to 32 states and Federal Capital Territory (FCT) in 2020. Ondo state (25.39%) had the highest of deaths rate from LF over the four years. Case fatality rate (CFR) of LF was highest in 2017 (26.5%) with CFR of 23.7, 19.6 and 13.4% in 2018, 2019 and 2020 respectively. The peak of infection was in the month of February for the four years. Infections increases at the onset of dry season in November and decline till April when the wet season sets-in. Conclusion There is an annual increase in the number of LASV infection across the states in Nigeria. There is need to heighten control strategies through the use of integrated approach, ranging from vector control, health education and early diagnosis.

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Implementation of MenACWY vaccination because of ongoing increase in serogroup W invasive meningococcal disease, the Netherlands, 2018

Eurosurveillance ◽

10.2807/1560-7917.es.2018.23.16.18-00158 ◽

2018 ◽

Vol 23 (16) ◽

Cited By ~ 18

Author(s):

Mirjam J Knol ◽

Wilhelmina LM Ruijs ◽

Laura Antonise-Kamp ◽

Hester E de Melker ◽

Arie van der Ende

Keyword(s):

The Netherlands ◽

Incidence Rate ◽

Meningococcal Disease ◽

Case Fatality Rate ◽

Clonal Complex ◽

Case Fatality ◽

Annual Incidence ◽

Invasive Meningococcal Disease ◽

Fatality Rate ◽

Annual Incidence Rate

The annual incidence rate of serogroup W invasive meningococcal disease in the Netherlands increased from < 0.05/100,000 (n < 10) before 2015 to 0.5/100,000 (n = 80) in 2017. Most isolates (94%) belong to clonal complex 11. The incidence rate is highest among < 5 year-olds and 15–24 year-olds. The case fatality rate was 12% (17/138) in 2015–2017. From May 2018, MenACWY vaccination replaces MenC vaccination at age 14 months and from October 2018, 13–14 year-olds are offered MenACWY vaccination.

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Increased Case‐Fatality Rate Associated with Outbreaks ofNeisseria meningitidisInfection, Compared with Sporadic Meningococcal Disease, in the United States, 1994–2002

Clinical Infectious Diseases ◽

10.1086/504804 ◽

2006 ◽

Vol 43 (1) ◽

pp. 49-54 ◽

Cited By ~ 68

Author(s):

Richard Brooks ◽

Christopher W. Woods ◽

Daniel K. Benjamin, Jr. ◽

Nancy E. Rosenstein

Keyword(s):

United States ◽

Meningococcal Disease ◽

Case Fatality Rate ◽

Case Fatality ◽

The United States ◽

Fatality Rate

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Patient and strain characteristics in relation to the outcome of meningococcal disease: a multivariate analysis

Epidemiology and Infection ◽

10.1017/s0950268800057472 ◽

1994 ◽

Vol 112 (1) ◽

pp. 115-124 ◽

Cited By ~ 27

Author(s):

R. J. P. M. Scholten ◽

H. A. Bijlmer ◽

H. A. Valkenburg ◽

J. Dankert

Keyword(s):

The Netherlands ◽

Meningococcal Disease ◽

Case Fatality Rate ◽

Fatal Outcome ◽

Age Groups ◽

Case Fatality ◽

Surface Characteristics ◽

Fatality Rate ◽

Increased Risk ◽

Meningococcal Strain

SummaryTo investigate the joint association of patient and strain characteristics with the outcome of meningococcal disease (MD), data were collected on 563 consecutive cases of MD reported between 1989 and 1990 in The Netherlands. The meningococcal isolates were characterized with regard to their surface characteristics. Sequelae occurred in 8.5% of the patients, and were only associated with the presence of bacteraemia. The case-fatality rate was 7.7%. Infants aged ≤ 5 months and patients in the age-groups of 10–19 years and ≥ 50 years had an increased risk for a fatal outcome compared with children from 6 months to 9 years old (Odds Ratios [ORs]: 5.1, 3.4 and 9.8, respectively). The OR for females versus males was 2.3. The ORs for patients with bacteraemia, or a combination of bacteraemia and meningitis, compared with meningitic patients, were 2.3 and 3.1. Meningococcal strain characteristics did not influence the case-fatality rate substantially. In conclusion, host factors were found to be determinants for a fatal outcome of MD in The Netherlands from 1989 to 1990.

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