Predicted coverage by 4CMenB vaccine against invasive meningococcal disease cases in the Netherlands

Abstract Background An increase in invasive meningococcal disease (IMD) serogroup W (IMD-W) cases caused by sequence type-11 clonal complex (cc11) was observed from October 2015 in the Netherlands. We compared the clinical picture and disease outcome of IMD-W cases with other serogroups, adjusting for host characteristics. Methods We included IMD cases reported from January 2015 to June 2018 in the Netherlands and assessed clinical manifestation and symptoms at disease onset and calculated case fatality rates (CFRs). We used logistic regression to compare clinical manifestations and mortality of IMD-W with IMD caused by meningococci serogroup B, Y, or C, adjusting for age, gender, and comorbidities. Results A total of 565 IMD cases were reported, of which 204 were IMD-W, 270 IMD-B, 63 IMD-Y, and 26 IMD-C. Most IMD-W isolates belonged to cc11 (93%; 175/188). Compared with other serogroups, IMD-W patients were diagnosed more often with septicemia (46%) or pneumonia (12%) and less often with meningitis (17%, P < .001). IMD-W cases presented more often with respiratory symptoms (45%, P < .001); 16% of IMD-W patients presented with diarrhea without IMD-specific symptoms (P = .061). The CFR for IMD-W was 16% (32/199, P < .001). The differences between IMD-W and other serogroups remained after adjusting for age, gender, and comorbidities. Conclusions The atypical presentation and severe outcome among IMD-W cases could not be explained by age, gender, and comorbidities. Almost all our IMD-W cases were caused by cc11. More research is needed to identify the bacterial factors involved in clinical presentation and severity of IMD-W cc11.

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Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016

10.21203/rs.2.513/v3 ◽

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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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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Disease Burden of Invasive Meningococcal Disease in the Netherlands Between June 1999 and June 2011: A Subjective Role for Serogroup and Clonal Complex

Clinical Infectious Diseases ◽

10.1093/cid/civ506 ◽

2015 ◽

Vol 61 (8) ◽

pp. 1281-1292 ◽

Cited By ~ 31

Author(s):

Susanne P. Stoof ◽

Gerwin D. Rodenburg ◽

Mirjam J. Knol ◽

Lidewij W. Rümke ◽

Sandra Bovenkerk ◽

...

Keyword(s):

The Netherlands ◽

Meningococcal Disease ◽

Disease Burden ◽

Clonal Complex ◽

Invasive Meningococcal Disease

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Effectiveness of meningococcal vaccines at reducing invasive meningococcal disease and pharyngeal Neisseria meningitidis carriage: A systematic review and meta-analysis

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1733 ◽

2020 ◽

Author(s):

Mark McMillan ◽

Abira Chandrakumar ◽

Hua Lin Rachael Wang ◽

Michelle Clarke ◽

Thomas R Sullivan ◽

...

Keyword(s):

Neisseria Meningitidis ◽

Meningococcal Disease ◽

Incidence Rate Ratio ◽

Meta Analysis ◽

Membrane Vesicle ◽

Invasive Meningococcal Disease ◽

Meningococcal Vaccines ◽

Unpublished Studies ◽

Group B ◽

4Cmenb Vaccine

Abstract Background Invasive meningococcal disease (IMD), caused by Neisseria meningitidis, leads to significant morbidity and mortality worldwide. This review aimed to establish the effectiveness of meningococcal vaccines at preventing IMD and N. meningitidis pharyngeal carriage. Methods A search within PubMed, Embase, Scopus, and unpublished studies up to 1st February 2020 was conducted. Results After removal of duplicates, 8565 were screened and 28 studies included. Protection was provided by meningococcal C vaccines for group C IMD (odds ratio (OR) 0·13 [95% CI, 0·07-0·23]), outer membrane vesicle (OMV) vaccines against group B IMD (OR 0·35 [0·25-0·48]), and meningococcal ACWY (MenACWY) vaccines against group ACWY IMD (OR 0·31 [0·20-0·49]). A single time series analysis found a reduction following an infant 4CMenB program (incidence rate ratio, 0·25 [0·19-0·36]). Multivalent MenACWY vaccines did not reduce carriage (relative risk [RR] 0·88 [0·66-1·18]), unlike monovalent A (RR 0·73 [0·61-0·85]), and C vaccines (RR 0·50 [0·26-0·97]). 4CMenB vaccine had no effect on group B carriage (RR 1·12 [0·90-1·40]). There was also no reduction in group B carriage following MenB-FHbp vaccination (RR 0.98 [0.53-1.79]). Conclusions Meningococcal conjugate C, ACWY, and OMV vaccines are effective at reducing IMD. A small number of studies demonstrate that monovalent C and A conjugate vaccines reduce pharyngeal N. meningitidis carriage. There is no evidence of carriage reduction for multivalent MenACWY, OMV, or recombinant meningococcal B vaccines, which has implications for immunisation strategies. Registration PROSPERO CRD42018082085

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Need for Optimisation of Immunisation Strategies Targeting Invasive Meningococcal Disease in the Netherlands

International Journal of Health Policy and Management ◽

10.15171/ijhpm.2015.168 ◽

2015 ◽

Vol 4 (11) ◽

pp. 757-761 ◽

Cited By ~ 4

Author(s):

Josefien Cornelie Minthe Bousema ◽

Joost Ruitenberg

Keyword(s):

The Netherlands ◽

Meningococcal Disease ◽

Invasive Meningococcal Disease

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Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016

10.21203/rs.2.513/v1 ◽

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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Evaluation of the surveillance system for invasive meningococcal disease (IMD) in the Netherlands, 2004 – 2016

10.21203/rs.2.513/v2 ◽

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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Culture-Confirmed Invasive Meningococcal Disease in Canada, 2010 to 2014: Characterization of Serogroup B Neisseria meningitidis Strains and Their Predicted Coverage by the 4CMenB Vaccine

mSphere ◽

10.1128/msphere.00883-19 ◽

2020 ◽

Vol 5 (2) ◽

Author(s):

Raymond S. W. Tsang ◽

Dennis K. S. Law ◽

Rosita De Paola ◽

Maria Giuliani ◽

Maria Stella ◽

...

Keyword(s):

Molecular Epidemiology ◽

Neisseria Meningitidis ◽

Meningococcal Disease ◽

Factor H ◽

Invasive Meningococcal Disease ◽

Effective Control ◽

Atlantic Region ◽

Content Type ◽

Laboratory Surveillance ◽

4Cmenb Vaccine

ABSTRACT The molecular epidemiology of culture-confirmed invasive meningococcal disease (IMD) in Canada from 2010 to 2014 was studied with an emphasis on serogroup B Neisseria meningitidis (MenB) isolates, including their predicted coverage by the 4CMenB vaccine. The mean annual incidence rates of culture confirmed IMD varied from 0.19/100,000 in Ontario to 0.50/100,000 in New Brunswick and 0.59/100,000 in Quebec. In both Quebec and Atlantic region, MenB was significantly more common than other serogroups, while in other provinces, both MenB and serogroup Y (MenY) were almost equally common. The majority of MenB cases (67.0%) were in those aged ≤24 years, while most MenC (75.0%) and MenY (69.6%) cases were in adults more than 24 years old. The 349 MenB isolates were grouped into 103 sequence types (STs), 90 of which belonged to 13 clonal complexes (CCs). A large number of 4CMenB antigen genes were found among the Canadian MenB, which is predicted to encode 50 factor H binding protein (fHbp) types, 40 NHBA types, and 55 PorA genotypes. Provinces and regions were found to have their own unique MenB STs. A meningococcal antigen typing system assay predicted an overall MenB coverage by 4CMenB to be 73.6%, with higher coverage predicted for the two most common STs: 100% for ST154 and 95.9% for ST269, leading to higher coverage in both the Atlantic region and Quebec. Higher coverage (81.4%) was also found for MenB recovered from persons aged 15 to 24 years, followed by strains from infants and children ≤4 years old (75.2%) and those aged 5 to 14 years (75.0%). IMPORTANCE Laboratory surveillance of invasive meningococcal disease (IMD) is important to our understanding of the evolving nature of the Neisseria meningitidis strain types causing the disease and the potential coverage of disease strains by the newly developed vaccines. This study examined the molecular epidemiology of culture-confirmed IMD cases in Canada by examining the strain types and the potential coverage of a newly licensed 4CMenB vaccine on Canadian serogroup B N. meningitidis strains. The strain types identified in different parts of Canada appeared to be unique as well as their predicted coverage by the 4CMenB vaccine. These data were compared to data obtained from previous studies done in Canada and elsewhere globally. For effective control of IMD, laboratory surveillance of this type was found to be essential and useful to understand the dynamic nature of this disease.

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