scholarly journals Multidisciplinary analysis of invasive meningococcal disease as a framework for continuous quality and safety improvement in regional Australia

2018 ◽  
Vol 7 (1) ◽  
pp. e000077
Author(s):  
Kathryn A Taylor ◽  
David N Durrheim ◽  
Tony Merritt ◽  
Peter Massey ◽  
John Ferguson ◽  
...  
Keyword(s):  
Public Health ◽  
Patient Safety ◽  
Meningococcal Disease ◽  
Clinical Governance ◽  
Invasive Meningococcal Disease ◽  
Phase Iii ◽  
Antibiotic Administration ◽  
Management Guidelines ◽  
Senior Clinician ◽  
Review Management

BackgroundSystem factors in a regional Australian health district contributed to avoidable care deviations from invasive meningococcal disease (IMD) management guidelines. Traditional root cause analysis (RCA) is not well-suited to IMD, focusing on individual cases rather than system improvements. As IMD requires complex care across healthcare silos, it presents an opportunity to explore and address system-based patient safety issues.ContextBaseline assessment of IMD cases (2005–2006) identified inadequate triage, lack of senior clinician review, inconsistent vital sign recording and laboratory delays as common issues, resulting in antibiotic administration delays and inappropriate or premature discharge.MethodsClinical governance, in partnership with clinical and public health services, established a multidisciplinary Meningococcal Reference Group (MRG) to routinely review management of all IMD cases. The MRG comprised representatives from primary care, acute care, public health, laboratory medicine and clinical governance. Baseline data were compared with two subsequent evaluation points (2011–2012 and 2013–2015).InterventionsPhase I involved multidisciplinary process mapping and development of a standardised audit tool from national IMD management guidelines. Phase II involved formalisation of group processes and advocacy for operational change. Phase III focused on dissemination of findings to clinicians and managers.ResultsGreatest care improvements were observed in the final evaluation. Median antibiotic delay decreased from 72 to 42 min and proportion of cases triaged appropriately improved from 38% to 75% between 2013 and 2015. Increasing fatal outcomes were attributed to the emergence of more virulent meningococcal serotypes.ConclusionsThe MRG was a key mechanism for identifying system gaps, advocating for change and enhancing communication and coordination across services. Employing IMD case review as a focus for district-level process reflection presents an innovative patient safety approach, combining the strengths of prospective hazard analysis with more traditional RCA methodologies.

scholarly journals The Cost and Public Health Burden of Invasive Meningococcal Disease Outbreaks: A Systematic Review

2013 ◽  
Vol 31 (7) ◽  
pp. 563-576 ◽  
Author(s):  
Andrea Anonychuk ◽  
Gloria Woo ◽  
Andrew Vyse ◽  
Nadia Demarteau ◽  
Andrea C. Tricco
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Meningococcal Disease ◽  
Disease Outbreaks ◽  
Invasive Meningococcal Disease ◽  
Public Health Burden ◽  
Health Burden ◽  
The Cost

scholarly journals Acquisition of Meningococcal Serogroup W-135 Carriage in Turkish Hajj Pilgrims Who Had Received the Quadrivalent Meningococcal Polysaccharide Vaccine

2012 ◽  
Vol 20 (1) ◽  
pp. 66-68 ◽  
Author(s):  
M. Ceyhan ◽  
M. Celik ◽  
E. T. Demir ◽  
V. Gurbuz ◽  
A. E. Aycan ◽  
...  
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Health Problem ◽  
Family Members ◽  
Public Health Problem ◽  
Polysaccharide Vaccine ◽  
Invasive Meningococcal Disease ◽  
Household Contacts ◽  
To Receive ◽  
Close Contacts

ABSTRACTInvasive meningococcal disease is a recognized public health problem worldwide, with a dynamic and changeable epidemiology. In Turkey, the second most common pathogenic meningococcal serogroup (after serogroup B) is W-135, including an epidemic in 2005, which has been strongly associated with Hajj pilgrims and their close contacts. In two studies conducted in 2010, we assessed meningococcal carriage in intending Turkish pilgrims to the Hajj when they attended to receive a plain polysaccharide vaccine against serogroups A, C, W-135, and Y and, upon their return, to determine the acquisition of meningococcal carriage by the pilgrims themselves and subsequently their household contacts. Nasopharyngeal swabs were obtained from pilgrims before the Hajj and upon their return. Swabs were then obtained from 39 household contacts of pilgrims who were shown to have acquired carriage during the Hajj. Of the 472 pilgrims before the Hajj, 63 (13%) were positive for meningococcal carriage, of which 52 cases (83%) were serogroup W-135. In the 296 pilgrims tested after the Hajj, 81 (27%) were positive for meningococcal carriage, including 74 (91%) with W-135. In 11 family members of pilgrims who acquired W-135 carriage at the Hajj, 10 (91%) had acquired carriage of serogroup W-135. This study illustrates the acquisition of meningococcal carriage, predominantly of serogroup W-135 by pilgrims attending the Hajj, and the transmission of this carriage to their family members on their return, explaining the source of W-135 meningococcal disease in Turkey.

scholarly journals Lesson learned from an outbreak of invasive meningococcal disease: how HTA could have provided an evidence-based approach for public health response

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Miglietta
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Central Italy ◽  
Invasive Meningococcal Disease ◽  
Evidence Based ◽  
Public Health Response ◽  
Population Groups ◽  
Response Planning ◽  
Health Response ◽  
Immunization Campaign

Abstract During 2015-2016 an outbreak of invasive meningococcal disease due to Neisseria meningitidis serogroup C ST-11 (cc11) occurred in Tuscany, a Region in Central Italy. Sixty-two cases with 13 deaths (13%) were recorded. Regional Authorities responded through a mass immunization campaign targeting all the age groups by offering free of charge a single dose of the tetravalent (ACWY) meningococcal conjugate vaccine or monovalent meningococcal C conjugate (MCC) vaccine. Nevertheless, the response was fragmented and the campaign did not reach the risk-population groups (i.e. men who have sex with men), that were identified only when a Regional outbreak investigation was implemented. Also linkage between cases (i.e. attending the same gay-venue) were identified at a second stage, not allowing prompt max-prophylaxis interventions. In such a situation, an evidence-based approach as Health Technology Assessment, could have informed public health emergency preparedness and response planning processes, i.e. by identifying through early warning alert systems similar ongoing clusters in Europe among specific population-groups and consequently better targeting the immunization campaign. The objective of this presentation is to explore through a practical example how HTA could provide an evidence-based approach for public health response during a real outbreak underlining lesson learned.

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 Invasive meningococcal disease with fatal outcome in a Swiss student visiting Berlin

2008 ◽  
Vol 13 (45) ◽  
Author(s):  
I Zuschneid ◽  
A Witschi ◽  
L Quaback ◽  
W Hellenbrand ◽  
N Kleinkauf ◽  
...  
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
National Level ◽  
Fatal Outcome ◽  
Relevant Information ◽  
Invasive Meningococcal Disease ◽  
Contact Tracing ◽  
Post Exposure Prophylaxis ◽  
Disease Notification ◽  
Public Health Action

Following the fatal invasive meningococcal disease in a Swiss student who had been visiting Berlin, several public health institutions on local, regional and national level cooperated to ensure that the appropriate measures such as contact tracing and post exposure prophylaxis were taken to prevent further cases. The incidence highlighted the importance of early disease notification and showed that if an infectious disease requiring public health action occurs in an international context, it is vital that relevant information is communicated to all levels of the public health systems of the countries involved.

scholarly journals Serogroup C invasive meningococcal disease among men who have sex with men and in gay-oriented social venues in the Paris region: July 2013 to December 2014

2015 ◽  
Vol 20 (3) ◽  
Author(s):  
L Aubert ◽  
M K Taha ◽  
N Boo ◽  
Y Le Strat ◽  
A E Deghmane ◽  
...  
Keyword(s):  
Public Health ◽  
Meningococcal Disease ◽  
Clonal Complex ◽  
Invasive Meningococcal Disease ◽  
Gay Community ◽  
Health Authorities ◽  
Public Health Authorities ◽  
Paris Region ◽  
Sex With Men

In November 2014, French public health authorities renewed the recommendation to target for vaccination against invasive meningococcal disease men who have sex with men (MSM) and all individuals ≥25 years attending social venues associated with the gay community. This policy was extended beyond the Paris region as a reaction to the continuing spread of serogroup C isolates belonging to a new lineage within clonal complex cc11 since the recommendation was first issued in July 2013.

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.

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