Increase of invasive meningococcal serogroup W disease in Europe, 2013 to 2017

Author:

Krone Manuel1ORCID,Gray Steve2ORCID,Abad Raquel3ORCID,Skoczyńska Anna4ORCID,Stefanelli Paola5,van der Ende Arie6,Tzanakaki Georgina7ORCID,Mölling Paula8,João Simões Maria9ORCID,Křížová Pavla10,Emonet Stéphane11,Caugant Dominique A.12ORCID,Toropainen Maija13,Vazquez Julio3,Waśko Izabela4ORCID,Knol Mirjam J.14ORCID,Jacobsson Susanne8,Rodrigues Bettencourt Célia9,Musilek Martin10ORCID,Born Rita15,Vogel Ulrich1,Borrow Ray2ORCID

Affiliation:

1. Institute for Hygiene and Microbiology, University of Würzburg, Würzburg, Germany

2. Meningococcal Reference Unit, Public Health England, Manchester, United Kingdom

3. Spanish Reference Laboratory for Meningococci, National Centre for Microbiology, Instituto de Salud Carlos III, Madrid, Spain

4. National Reference Centre for Bacterial Meningitis, National Medicines Institute, Warsaw, Poland

5. Dept. of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy

6. The Netherlands Reference Laboratory for Bacterial Meningitis, Department of Medical Microbiology, Academic Medical Center, Amsterdam, Netherlands

7. National Meningitis Reference Laboratory, National School of Public Health, Athens, Greece

8. National Reference Laboratory for Neisseria meningitidis, Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden

9. Department of Infectious Diseases, National Institute of Health Dr. Ricardo Jorge, Lisboa, Portugal

10. National Reference Laboratory for Meningococcal Infections, National Institute of Public Health, Prague, Czech Republic

11. Division of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland

12. Division for Infection Control and Environmental Health, Norwegian Institute of Public Health, Oslo, Norway

13. Department of Health Security, National Institute for Health and Welfare (THL), Helsinki, Finland

14. Department of Epidemiology and Surveillance, National Institute for Public Health and the Environment, Bilthoven, the Netherlands

15. Division of Communicable Diseases, Federal Office of Public Health (FOPH), Bern, Switzerland

Abstract

Background The total incidence of invasive meningococcal disease (IMD) in Europe has been declining in recent years; however, a rising incidence due to serogroup W (MenW), predominantly sequence type 11 (ST-11), clonal complex 11 (cc11), was reported in some European countries. Aim The aim of this study was to compile the most recent laboratory surveillance data on MenW IMD from several European countries to assess recent trends in Europe. Methods In this observational, retrospective study, IMD surveillance data collected from 2013–17 by national reference laboratories and surveillance units from 13 European countries were analysed using descriptive statistics. Results The overall incidence of IMD has been stable during the study period. Incidence of MenW IMD per 100,000 population (2013: 0.03; 2014: 0.05; 2015: 0.08; 2016: 0.11; 2017: 0.11) and the proportion of this serogroup among all invasive cases (2013: 5% (116/2,216); 2014: 9% (161/1,761); 2015: 13% (271/2,074); 2016: 17% (388/2,222); 2017: 19% (393/2,112)) continuously increased. The most affected countries were England, the Netherlands, Switzerland and Sweden. MenW was more frequent in older age groups (≥ 45 years), while the proportion in children (< 15 years) was lower than in other age groups. Of the culture-confirmed MenW IMD cases, 80% (615/767) were caused by hypervirulent cc11. Conclusion During the years 2013–17, an increase in MenW IMD, mainly caused by MenW cc11, was observed in the majority of European countries. Given the unpredictable nature of meningococcal spread and the epidemiological potential of cc11, European countries may consider preventive strategies adapted to their contexts.

Publisher

European Centre for Disease Control and Prevention (ECDC)

Subject

Virology,Public Health, Environmental and Occupational Health,Epidemiology

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