当前脑膜炎奈瑟菌病的流行病学和趋势-美国,1996-2015 年。

Current Epidemiology and Trends in Meningococcal Disease-United States, 1996-2015.

机构信息

National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

Clin Infect Dis. 2018 Apr 3;66(8):1276-1281. doi: 10.1093/cid/cix993.

Abstract

BACKGROUND

In 2005, meningococcal conjugate vaccine (MenACWY) was recommended for routine use among adolescents aged 11-18 years. This report describes the epidemiologic features of meningococcal disease and trends in meningococcal disease incidence following MenACWY introduction in the United States.

METHODS

Incidence rates and case-fatality ratios by age group and serogroup during 2006-2015 were calculated using data from the National Notifiable Diseases Surveillance System (NNDSS); changes in incidence during this time were evaluated. Additionally, 20-year trends (1996-2015) in age- and race-standardized incidence were examined using data from Active Bacterial Core surveillance (ABCs).

RESULTS

During the years 2006-2015, 7924 cases of meningococcal disease were reported to NNDSS, resulting in an average annual incidence of 0.26 cases per 100000 population; 14.9% of cases were fatal. Among cases with serogroup information, 2290 (35.8%) were serogroup B, 1827 (28.5%) were serogroup Y, 1457 (22.8%) were serogroup C, 436 (6.8%) were serogroup W, and 392 (6.1%) were other serogroups. The incidence of serogroups A, C, W, and Y combined declined 76% among persons aged 11-20 years from 2006-2010 to 2011-2015 (P < .0001). From 1996 through 2015, the incidence of meningococcal disease declined among all age groups and predominant serogroups.

CONCLUSIONS

Declines in meningococcal disease incidence in the United States have been observed among all age groups and predominant serogroups (B, C, and Y). Reductions in the incidence of meningococcal disease due to serogroups A, C, W, and Y among adolescents suggest an impact of the MenACWY vaccine program in this age group.

摘要

背景

2005 年,脑膜炎球菌结合疫苗(MenACWY)被推荐用于 11-18 岁青少年的常规使用。本报告描述了美国引入脑膜炎球菌结合疫苗后,脑膜炎球菌疾病的流行病学特征和发病率趋势。

方法

使用国家法定传染病监测系统(NNDSS)的数据计算了 2006-2015 年期间按年龄组和血清群划分的发病率和病死率比;评估了在此期间发病率的变化。此外,使用主动细菌核心监测(ABCs)的数据,检查了 20 年(1996-2015 年)年龄和种族标准化发病率的趋势。

结果

在 2006-2015 年期间,NNDSS 报告了 7924 例脑膜炎球菌病病例,导致平均每年每 100000 人口中有 0.26 例病例;14.9%的病例是致命的。在有血清群信息的病例中,2290 例(35.8%)为血清群 B,1827 例(28.5%)为血清群 Y,1457 例(22.8%)为血清群 C,436 例(6.8%)为血清群 W,392 例(6.1%)为其他血清群。2006-2010 年至 2011-2015 年期间,11-20 岁人群中血清群 A、C、W 和 Y 联合发病率下降了 76%(P<0.0001)。从 1996 年到 2015 年,所有年龄组和主要血清群的脑膜炎球菌病发病率都有所下降。

结论

在美国,所有年龄组和主要血清群(B、C 和 Y)的脑膜炎球菌病发病率都有所下降。青少年中由于血清群 A、C、W 和 Y 导致的脑膜炎球菌病发病率下降表明 MenACWY 疫苗计划在该年龄组中产生了影响。

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