Whittaker Robert, Dias Joana Gomes, Ramliden Miriam, Ködmön Csaba, Economopoulou Assimoula, Beer Netta, Pastore Celentano Lucia
European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.
European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.
Vaccine. 2017 Apr 11;35(16):2034-2041. doi: 10.1016/j.vaccine.2017.03.007. Epub 2017 Mar 14.
Invasive meningococcal disease (IMD) is a major cause of bacterial meningitis and septicaemia although infection by some serogroups may be prevented through vaccination. We aimed to describe the epidemiology of IMD in EU/EEA countries during 2004-2014 to monitor serogroup- and age-specific trends, and compare country trends by the period of meningococcal C conjugate (MCC) vaccine introduction.
We analysed IMD surveillance data by age, gender, serogroup, country and outcome. We estimated the percentage change in annual notification rate (NR), using linear regression analysis of the log of the annual NR. We grouped countries by the year they introduced MCC vaccination into their routine immunisation programmes.
The overall NR was 0.9/100 000 population, and decreased 6.6% (95%CI: -8.0%;-5.1%) annually. Infants had the highest NR (16.0/100 000), and there were decreasing trends in all age groups <50years. Serogroup B (SgB) caused 74% of all cases, and the majority of cases in all age groups. There were decreasing trends in SgB and serogroup C (SgC) and an increasing trend in serogroup Y. Countries that introduced MCC vaccination before, and between 2004 and 2014, had decreasing trends in NR of SgC, but not countries without routine MCC vaccination.
Our findings support evidence that routine MCC vaccination was the driving force behind the decreasing SgC trend. Vaccinating against SgB in the first year of life could help reduce the burden of IMD due to this serogroup. Changing serogroup-specific NR trends highlight the need for high-quality surveillance data to accurately assess the changing epidemiology of IMD, the effectiveness and impact of implemented vaccines, and the need for future vaccines.
侵袭性脑膜炎球菌病（IMD）是细菌性脑膜炎和败血症的主要病因，不过某些血清群的感染可通过接种疫苗预防。我们旨在描述2004 - 2014年期间欧盟/欧洲经济区国家IMD的流行病学情况，监测血清群和年龄特异性趋势，并按脑膜炎球菌C结合疫苗（MCC）引入时间比较各国趋势。
我们按年龄、性别、血清群、国家和结局分析了IMD监测数据。我们使用年度报告率（NR）对数的线性回归分析估计年度报告率的百分比变化。我们按将MCC疫苗引入其常规免疫规划的年份对国家进行分组。
总体报告率为每10万人口0.9例，且每年下降6.6%（95%置信区间：-8.0%；-5.1%）。婴儿的报告率最高（每10万人口16.0例），且所有<50岁年龄组的报告率均呈下降趋势。B血清群（SgB）导致了所有病例的74%，且在所有年龄组中占大多数病例。SgB和C血清群（SgC）呈下降趋势，Y血清群呈上升趋势。在2004年之前以及2004年至2014年期间引入MCC疫苗的国家，SgC的报告率呈下降趋势，但未实施常规MCC疫苗接种的国家则不然。
我们的研究结果支持以下证据，即常规MCC疫苗接种是SgC趋势下降的驱动力。在生命的第一年接种SgB疫苗有助于减轻该血清群所致IMD的负担。血清群特异性报告率趋势的变化凸显了需要高质量监测数据，以准确评估IMD不断变化的流行病学情况、已实施疫苗的有效性和影响，以及对未来疫苗的需求。
