澳大利亚 1999-2015 年侵袭性 B 型脑膜炎奈瑟菌病的流行病学：疫苗接种的重点人群。

Epidemiology of invasive meningococcal B disease in Australia, 1999-2015: priority populations for vaccination.

机构信息

National Centre for Immunisation Research and Surveillance (NCIRS), Sydney, NSW

National Centre for Immunisation Research and Surveillance (NCIRS), Sydney, NSW.

出版信息

Med J Aust. 2017 Nov 6;207(9):382-387. doi: 10.5694/mja16.01340.

DOI:10.5694/mja16.01340

PMID:29092704

Abstract

OBJECTIVES

To describe trends in the age-specific incidence of serogroup B invasive meningococcal disease (IMD) in Australia, 1999-2015.

DESIGN, SETTING, PARTICIPANTS: Analysis in February 2017 of de-identified notification data from the Australian National Notifiable Diseases Surveillance System of all notifications of IMD in Australia with a recorded diagnosis date during 1999-2015.Major outcomes: IMD notification rates in Australia, 1999-2015, by age, serogroup, Indigenous status, and region.

RESULTS

The incidence of meningococcal serogroup B (MenB) disease declined progressively from 1.52 cases per 100 000 population in 2001 to 0.47 per 100 000 in 2015. During 2006-2015, MenB accounted for 81% of IMD cases with a known serogroup; its highest incidence was among infants under 12 months of age (11.1 [95% CI, 9.81-12.2] per 100 000), children aged 1-4 years (2.82 [95% CI, 2.52-3.15] per 100 000), and adolescents aged 15-19 years (2.40 [95% CI, 2.16-2.67] per 100 000). Among the 473 infants under 2 years of age with MenB, 43% were under 7 months and 69% under 12 months of age. The incidence of meningococcal serogroup C (MenC) disease prior to the introduction of the MenC vaccine in 2003 was much lower in infants than for MenB (2.60 cases per 100 000), the rate peaking in people aged 15-19 years (3.32 per 100 000); the overall case fatality rate was also higher (MenC, 8%; MenB, 4%). The incidence of MenB disease was significantly higher among Indigenous than non-Indigenous Australians during 2006-2015 (incidence rate ratio [IRR], 3.8; 95% CI, 3.3-4.5).

CONCLUSIONS

Based on disease incidence at its current low endemic levels, priority at risk age/population groups for MenB vaccination include all children between 2 months and 5 years of age, Indigenous children under 10 years of age, and all adolescents aged 15-19 years. Given marked variation in meningococcal disease trends over time, close scrutiny of current epidemiologic data is essential.

摘要

目的

描述澳大利亚 1999-2015 年 B 群侵袭性脑膜炎奈瑟菌病（meningococcal disease，IMD）年龄特异性发病率的趋势。

设计、地点和参与者：2017 年 2 月，对澳大利亚国家传染病监测系统中记录的 1999-2015 年期间所有 IMD 病例的确诊日期进行分析。

主要结局

1999-2015 年澳大利亚 IMD 通报率，按年龄、血清群、土著身份和地区划分。

结果

B 群脑膜炎奈瑟菌（MenB）疾病的发病率从 2001 年的每 100 000 人 1.52 例逐渐下降到 2015 年的每 100 000 人 0.47 例。在 2006-2015 年期间，MenB 占已知血清群 IMD 病例的 81%；发病率最高的是 12 个月以下的婴儿（每 100 000 人中有 11.1[95%可信区间，9.81-12.2]例）、1-4 岁儿童（每 100 000 人中有 2.82[95%可信区间，2.52-3.15]例）和 15-19 岁青少年（每 100 000 人中有 2.40[95%可信区间，2.16-2.67]例）。在 473 例 2 岁以下的 MenB 婴儿中，43%的婴儿小于 7 个月，69%的婴儿小于 12 个月。在 2003 年引入 MenC 疫苗之前，MenC 血清群疾病的发病率在婴儿中明显低于 MenB（每 100 000 人中有 2.60 例），发病率在 15-19 岁人群中达到峰值（每 100 000 人中有 3.32 例）；总体病死率也更高（MenC，8%；MenB，4%）。在 2006-2015 年期间，澳大利亚土著居民的 MenB 疾病发病率明显高于非土著居民（发病率比[IRR]，3.8；95%可信区间，3.3-4.5）。