Increase in Endemic Neisseria meningitidis Capsular Group W Sequence Type 11 Complex Associated With Severe Invasive Disease in England and Wales
Background. In England and Wales, the incidence of invasive meningococcal disease has been declining for more than a decade, but meningococcal group W (MenW) cases have been increasing since 2009. Methods. Public Health England conducts enhanced national surveillance of invasive meningococcal disease in England and Wales. Detailed clinical information was obtained for all laboratory-confirmed Men W cases diagnosed during 3 epidemiologic years (2010–2011 to 2012–2013), alongside whole-genome sequencing analysis of the clinical isolates. Results. The year-on-year increase in invasive MenW disease across all age groups since 2009–2010 was due to rapid endemic expansion of a single clone belonging to the sequence type 11 complex (cc11). In 2013–2014, MenW was responsible for 15% of all invasive meningococcal disease. All but 1 of the recent MenW:cc11 isolates were very closely related, consistent with recent clonal expansion. Clinical follow-up of all 129 MenW cases diagnosed during 2010–2011 to 2012–2013 revealed that most patients were previously healthy (n= 105 [81%]), had not travelled abroad prior to illness and the majority presented with septicemia (n = 63 [49%]), meningitis (n = 16 [12%]) or both (n = 21 [16%]); however, one-quarter had atypical presentations including pneumonia (n= 15 [12%]), septic arthritis (n = 9 [7%]), and epiglottitis/supraglottitis (n = 5 [4%]). Forty-eight (37%) required intensive care and 15 (12%) died. There was no association between infecting strain, clinical disease, or outcome. Conclusions. The recent increase in invasive MenW disease in England and Wales is due to rapid endemic expansion of a single clone belonging to cc11 and is associated with severe disease with unusual clinical presentations. This increase will require careful monitoring in the coming years..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:60 |
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| Enthalten in: |
Clinical Infectious Diseases - 60(2015), 4, Seite 578-585 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ladhani, Shamez N. [VerfasserIn] |
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JST128334223 |
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| 520 | |a Background. In England and Wales, the incidence of invasive meningococcal disease has been declining for more than a decade, but meningococcal group W (MenW) cases have been increasing since 2009. Methods. Public Health England conducts enhanced national surveillance of invasive meningococcal disease in England and Wales. Detailed clinical information was obtained for all laboratory-confirmed Men W cases diagnosed during 3 epidemiologic years (2010–2011 to 2012–2013), alongside whole-genome sequencing analysis of the clinical isolates. Results. The year-on-year increase in invasive MenW disease across all age groups since 2009–2010 was due to rapid endemic expansion of a single clone belonging to the sequence type 11 complex (cc11). In 2013–2014, MenW was responsible for 15% of all invasive meningococcal disease. All but 1 of the recent MenW:cc11 isolates were very closely related, consistent with recent clonal expansion. Clinical follow-up of all 129 MenW cases diagnosed during 2010–2011 to 2012–2013 revealed that most patients were previously healthy (n= 105 [81%]), had not travelled abroad prior to illness and the majority presented with septicemia (n = 63 [49%]), meningitis (n = 16 [12%]) or both (n = 21 [16%]); however, one-quarter had atypical presentations including pneumonia (n= 15 [12%]), septic arthritis (n = 9 [7%]), and epiglottitis/supraglottitis (n = 5 [4%]). Forty-eight (37%) required intensive care and 15 (12%) died. There was no association between infecting strain, clinical disease, or outcome. Conclusions. The recent increase in invasive MenW disease in England and Wales is due to rapid endemic expansion of a single clone belonging to cc11 and is associated with severe disease with unusual clinical presentations. This increase will require careful monitoring in the coming years. | ||
| 540 | |a Copyright © 2015 Oxford University Press on behalf of the Infectious Diseases Society of America | ||
| 655 | 4 | |a research-article | |
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| 700 | 1 | |a Lucidarme, Jay |e verfasserin |4 aut | |
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| 700 | 1 | |a Gray, Steve |e verfasserin |4 aut | |
| 700 | 1 | |a Kaczmarski, Ed |e verfasserin |4 aut | |
| 700 | 1 | |a Ramsay, Mary E. |e verfasserin |4 aut | |
| 700 | 1 | |a Borrow, Ray |e verfasserin |4 aut | |
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