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Euro Surveill. 2019 Apr;24(14). doi: 10.2807/1560-7917.ES.2019.24.14.1800245.

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

Author information

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

BackgroundThe 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.AimThe 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.MethodsIn 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.ResultsThe 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.ConclusionDuring 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.

KEYWORDS:

Europe; Neisseria menigitidis; airborne infections; bacterial infections; epidemiology; meningococcal disease; serogroup W; surveillance

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