Martínez Ana I, Domínguez Angela, Oviedo Manuel, Minguell Sofía, Jansà Josep M, Codina Gemma, Vázquez Julio A
Departamento de Salud, Generalitat de Cataluña, Barcelona, España.
Rev Esp Salud Publica. 2009 Sep-Oct;83(5):725-35. doi: 10.1590/s1135-57272009000500013.
Meningococcal disease remains a serious public health problem worldwide. In Catalonia, after implementing the vaccination program, there has been a significant decrease in cases caused by meningococcus C.
Reported cases of meningococcal disease between 1997 and 2008 were analyzed to determine the evolution after the introduction of a conjugated vaccine in Catalonia.
In < 6 years, the incidence rate of serogroup C fell from 7.6 to 0.6 per 100,000 persons/year in the periods before (1997-2000) and after (2001-2007) the introduction of the conjugate vaccine. In serogroup B, the reduction was from 15.4 to 11.1. In < 20 years case-fatality-rate increased only in serogroup B (3% and 7.4%). Serosubtype P1.15was the most frequent in serogroup B (31%), mainly associated with serotype 4 (80%), and in serogroup C subtype P1.5 (36%), with serotype 2a (86%). During 2008, 5 apparently unrelated cases of B:2a:P1.5 were identified in the same geographic area, with a case-fatality-rate of 80%.
Exhaustive surveillance of circulating meningococcal strains is essential.
脑膜炎球菌病在全球范围内仍是一个严重的公共卫生问题。在加泰罗尼亚，实施疫苗接种计划后，由C群脑膜炎球菌引起的病例显著减少。
分析了1997年至2008年报告的脑膜炎球菌病病例，以确定加泰罗尼亚引入结合疫苗后的演变情况。
在6岁以下儿童中，结合疫苗引入前（1997 - 2000年）C群的发病率为每10万人年7.6例，引入后（2001 - 2007年）降至每10万人年0.6例。在B群中，发病率从15.4降至11.1。在20岁以下人群中，病死率仅在B群有所上升（3%和7.4%）。B群中P1.15血清亚型最为常见（31%），主要与4型（80%）相关，C群中P1.5亚型（36%）最为常见，与2a型（86%）相关。2008年，在同一地理区域发现了5例明显无关的B:2a:P1.5病例，病死率为80%。
对循环中的脑膜炎球菌菌株进行详尽监测至关重要。
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