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

2018 ◽  
Vol 23 (16) ◽  
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.

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

2006 ◽  
Vol 46 (2) ◽  
pp. 230-235 ◽  
Author(s):  
Anna SkoczyÅ„ska ◽  
Marcin KadÅ‚ubowski ◽  
Józef 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

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

1994 ◽  
Vol 112 (1) ◽  
pp. 115-124 ◽  
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.

scholarly journals Invasive meningococcal disease in Malta: an epidemiological overview, 1994–2007

2009 ◽  
Vol 58 (11) ◽  
pp. 1492-1498 ◽  
Author(s):  
Mark Muscat ◽  
Gianfranco Spiteri ◽  
Neville Calleja ◽  
Julie Haider ◽  
Stephen J. Gray ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Invasive Meningococcal Disease ◽  
Fatality Rate ◽  
Crude Incidence ◽  
Laboratory Surveillance ◽  
Methods Of Control

Since 1996, Malta has experienced an upsurge of invasive meningococcal disease (IMD) following an almost 30 year period with a negligible number of annually reported cases. We reviewed the 233 IMD cases notified during a 14 year period (1994–2007), and analysed epidemiological and laboratory surveillance data. The crude incidence per 100 000 inhabitants peaked in 2000 at 8.1 [95 % confidence interval (CI) 5.7–11.6] and again in 2006 at 8.9 (95 % CI 6.4–12.4), thereby placing Malta amongst the countries with the highest incidence of the disease in Europe. Of the total cases, 137 (59 %) were confirmed and 30 (13 %) were classified as probable. However, 66 cases (28 %) had no laboratory evidence of the disease and were classified as possible. Information on the serogroup was available for 114 cases. Serogroup B formed the largest proportion (76 %, n=87) followed by serogroup C (16 %, n=18). B : 4 : P1.19,15 strains (n=46) predominated throughout the study period since their first identification in 1998. With 28 deaths attributed to IMD, the overall case fatality rate was 12 %. Apart from stressing the importance of maintaining high vigilance for IMD, our findings underscore the importance of enhancing laboratory surveillance of the disease, including characterization of the meningococci. Until vaccines against a broad range of serogroup B meningococci become available for universal use, the main methods of control remain the early treatment of cases and the prevention of secondary cases.

scholarly journals Epidemiology of invasive meningococcal disease in France in 2003

2005 ◽  
Vol 10 (12) ◽  
pp. 9-10 ◽  
Author(s):  
A Perrocheau ◽  
M K Taha ◽  
D Lévy-Bruhl
Keyword(s):  
Meningococcal Disease ◽  
Case Fatality Rate ◽  
Detection System ◽  
Purpura Fulminans ◽  
Case Fatality ◽  
Case Definition ◽  
Mandatory Reporting ◽  
Invasive Meningococcal Disease ◽  
Fatality Rate ◽  
Alert Threshold

National surveillance of invasive meningococcal disease (IMD) is based on mandatory reporting. The case definition for surveillance notification was changed in mid-2002 to include cases without microbiological confirmation. The IMD alert detection system was enhanced in 2003 with daily reporting and weekly analysis by district, serogroup, and age. Evaluation of the exhaustivity of the surveillance with capture-recapture analysis allowed correcting for underreporting. In 2003, 803 cases were reported. After correction for under-reporting, the estimated incidence was 1.78 / 100 000. After excluding ‘new’ cases reported with new definition criteria, the 2002-2003 increase was 4%. Incidence decreased with age, with the highest values in infants less than 1 year (20/100 000), children aged between 1 and 2 years (11/100 000) and in teenagers of 17 years old(7/100 000). The overall case fatality rate was 12%. Fifty nine per cent of cases were due to serogroup B, 32% to C, 5% to W135, and 4% to Y and non-groupable meningococci. Patients with purpura fulminans treated with intravenous antibiotics before admission to hospital were shown to have lower fatality rates than those not treated. In 2001-2003, 5 situations required particular attention: two clusters of serogroup B IMD had set off mass prophylaxis, one outbreak due to a specific B IMD clonal complex with high case fatality rate, and two districts crossed the alert threshold for serogroup C IMD, 2/100 000, and mass vaccination was recommended.

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

2005 ◽  
Vol 134 (1) ◽  
pp. 103-110 ◽  
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.

scholarly journals Risk factors for incidence and case-fatality rates of healthcare-associated infections: a 20-year follow-up of a hospital-based cohort

2015 ◽  
Vol 144 (1) ◽  
pp. 198-206 ◽  
Author(s):  
R.-F. WANG ◽  
S.-H. SHEN ◽  
A. M.-F. YEN ◽  
T.-L. WANG ◽  
T.-N. JANG ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Incidence Rate ◽  
Case Fatality Rate ◽  
Tertiary Care ◽  
Case Fatality ◽  
Healthcare Associated Infections ◽  
Fatality Rate ◽  
Infection Site ◽  
Healthcare Associated

SUMMARYInformation is lacking on the integrated evaluation of mortality rates in healthcare-associated infections (HAIs). Our aim was to differentiate the risk factors responsible for the incidence from those for the case-fatality rates in association with HAIs. We therefore examined the time trends of both incidence and case-fatality rates over a 20-year period at a tertiary-care teaching medical centre in Taiwan and the mortality rate was expressed as the product of the incidence rate and the case-fatality rate. During the study period the overall mortality rate fell from 0·46 to 0·32 deaths/1000 patient-days and the incidence rate fell from 3·41 to 2·31/1000 patient-days, but the case-fatality rate increased marginally from 13·5% to 14·0%. The independent risk factors associated with incidence of HAIs were age, gender, infection site, admission type, and department of hospitalization. Significant prognostic factors for HAI case-fatality were age, infection site, intensive care, and clinical department. We conclude that the decreasing trend for the HAI mortality rate was accompanied by a significant decline in the incidence rate and this was offset by a slightly increasing trend in the case-fatality rate. This deconstruction approach could provide further insights into the underlying complex causes of mortality for HAIs.

Ximelagatran Versus Warfarin: A Comparison of Bleeding Outcomes in Patients with Nonvalvular Atrial Fibrillation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1765-1765
Author(s):  
James D. Douketis ◽  
Karin Arneklev ◽  
Samuel Goldhaber ◽  
John Spandorfer ◽  
Frank Halperin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Major Bleeding ◽  
Lower Risk ◽  
Case Fatality Rate ◽  
Time Course ◽  
Case Fatality ◽  
Annual Incidence ◽  
Bleeding Complications ◽  
Fatality Rate ◽  
Nonvalvular Atrial Fibrillation

Abstract Background: The conventional anticoagulant management of patients with nonvalvular atrial fibrillation (AF) involves warfarin, administered to achieve a target international normalized ratio (INR) of 2.0–3.0. Ximelagatran is a novel oral direct thrombin inhibitor that, unlike warfarin, has a predictable anticoagulant effect and does not require dose adjustments based on the INR. In the SPORTIF III and V trials, ximelagatran was as effective as warfarin in preventing stroke and other thromboembolic complications in patients with nonvalvular AF. However, these studies were not designed to determine if ximelagatran was associated with a lower risk of major bleeding. Furthermore, these studies did not compare the case-fatality rate, time course, and anatomic sites of bleeding in ximelagatran- and warfarin-treated patients. Methods: We undertook a pooled analysis of the SPORTIF III and V trials that involved 7329 patients with AF who received oral ximelagatran, 36 mg twice daily, or warfarin, administered to achieve a target INR of 2.0–3.0. Patients had nonvalvular AF and 1 or more risk factors for stroke: hypertension; age ≥75 yrs; previous stroke, transient ischemic attack or systemic embolism; left ventricular dysfunction; age ≥65 yrs and coronary artery disease; or age ≥65 yrs and diabetes. Major exclusion criteria were: mitral stenosis; previous heart valve surgery; transient AF; and increased risk for bleeding. Bleeding event rates were compared using Fisher’s exact test and the log-rank test and were expressed as the number of bleeds per year. The case-fatality rate of major bleeding was defined as the number of fatal bleeds divided by fatal plus nonfatal bleeds. Results: The annual incidence of major bleeding was 2.0% in ximelagatran-treated patients and 2.7% in warfarin-treated patients (P = 0.029). The annual incidence of any (major or minor) bleeding was 31.7% in ximelagatran-treated patients and 38.8% in warfarin-treated patients (P < 0.0001). If episodes of intracranial hemorrhage were excluded, the annual incidence of major bleeding was 1.9% in ximelagatran-treated patients and 2.4% in warfarin-treated patients (P = 0.054). The case-fatality rate of major bleeding was 8.2% in ximelagatran-treated and 8.1% in warfarin-treated patients (P = 0.98). The time course and anatomic sites of major bleeding were not significantly different in ximelagatran-treated and warfarin-treated patients. Most bleeds involved the gastrointestinal tract, urinary tract or soft tissues. Conclusion: In patients with nonvalvular AF who require long-term anticoagulation, treatment with oral ximelagatran, 36 mg twice daily, is associated with a lower risk of bleeding complications than warfarin.

scholarly journals Profile of acute poisoning in three health districts of Botswana

2009 ◽  
Vol 1 (1) ◽  
Author(s):  
Mary Kasule ◽  
Ntambwe Malangu
Keyword(s):  
Incidence Rate ◽  
Case Fatality Rate ◽  
Case Fatality ◽  
Acute Poisoning ◽  
Fatality Rate ◽  
Urban District ◽  
Natural Toxins ◽  
Household Products ◽  
Age Category ◽  
Health Districts

Background: This study sought to characterise acute poisoning cases seen in three health districts of Botswana.Method: A retrospective review of patients’ records was conducted and included patients treated from January 2004 to December 2005. Data on the demographic status of the patients, information about the poisonous agent(s) involved, and the circumstances and outcomes of the poisoning incidents were recorded on a pre-tested data collection form.Results: A total of 590 cases of acute poisoning were included in the analysis. The most affected age category was that of children aged less than six years, who constituted 33.4% of the cases. Most incidents were recorded in the urban district of Gaborone. Seventy-eight percent (78%) of the incidents were accidental, with the remainder being intentional. The poisonous agents involved were pharmaceuticals (26.6%), natural toxins (25.6%), household products (14.6%), foods (14.4%), alcohol (6.9%), traditional medicines (4.7%), unspecified agents (3.2%), and agrochemicals (2.7%). The most common route of poison exposure was by oral (82.2%), followed by dermal contact (16.5%), while the inhalation of gases occurred in 1.2% of cases. An incidence rate of 4.7/1000, a case fatality rate of 3.8/100, and 1.5% of deaths were recorded over the two-year period.Conclusion: In conclusion, it can be stated that acute poisoning involved mainly young children and resulted in an incidence rate of 4.7/1000, a case fatality rate of 3.8/100, and 1.5% of deaths over the two-year period. There were differences based on age category, gender and residence of the victims, the types of toxic agents involved, as well as the circumstances and the outcomes of the poisoning incidents. Given the fact that pharmaceuticals, natural toxins, household products and foods were the agents most commonly involved, targeted interventions should take these differences into account in addressing the problem of acute poisoning.

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

2008 ◽  
Vol 13 (10) ◽  
pp. 1-2 ◽  
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.

scholarly journals Aneurysmal subarachnoid hemorrhage: long-term trends in incidence and survival in Olmsted County, Minnesota

2020 ◽  
pp. 1-6
Author(s):  
Enrico Giordan ◽  
Christopher S. Graffeo ◽  
Alejandro A. Rabinstein ◽  
Robert D. Brown ◽  
Walter A. Rocca ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Incidence Rate ◽  
Case Fatality Rate ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Case Fatality ◽  
Population Based ◽  
Fatality Rate ◽  
Olmsted County ◽  
Day Case ◽  
Incident Cases

OBJECTIVERecent population-based and hospital cohort studies have reported a decreasing incidence of aneurysmal subarachnoid hemorrhage (aSAH) and declining aSAH-associated case-fatality rates. Principal drivers of these trends are debated, but improvements in smoking cessation and hypertension control may be critical factors.METHODSThe population-based medical records linkage system of the Rochester Epidemiological Project was used to document aSAH incidence and 30-day case fatality rates during a 20-year study period (1996–2016) in Olmsted County, Minnesota. Incidence rates in the study period were compared with data from a previous Olmsted County study concerning aSAH incidence from 1965 to 1995 and with regional trends in tobacco use.RESULTSOne hundred nineteen incident cases of aSAH were included. The median age at hemorrhage was 59 years (range 16–94 years), and 74 patients were female (62.2%). The overall average annual aSAH incidence rate was 4.2/100,000 person-years (P-Y). The aSAH incidence rate decreased from 5.7/100,000 in 1996 to 3.5/100,000 P-Y in 2011–2016. The overall aSAH-associated 30-day case-fatality rate was 21.9% and declined by approximately 0.5% annually. An accelerated decline in the fatality rate (0.9%/year) was observed from 2006–2016. Smoking among adult Olmsted County residents decreased from 20.4% in 2000 to 9.1% in 2018.CONCLUSIONSA decline in the incidence of aSAH and 30-day case-fatality rate from 1996 to 2016 was observed, as well as an accelerated decline of the fatality rate from 2006 to 2016. These findings confirm and extend the trends reported by prior studies in the same population. The decrease in aSAH in the years studied paralleled a noticeable reduction in the population smoking rates.

Sign in / Sign up

Export Citation Format

Share Document