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This presentation was created and presented by Marta Busana from ECDC during the Invasive Bacterial Diseases laboratory network/ECDC Vaccine-preventable diseases network meeting in Barcelona, July 2012.
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Invasive meningococcal disease (IMD)
Marta Busana Scientific Officer on Vaccine Preventable Disease (VPD) Surveillance and Response Support Unit European Centre for Disease Prevention and Control (ECDC) Barcelona, November 2012
IMD surveillance system, EU\EEA 2011
Universal / Sentinel: 29 universal, 1 sentinel
Passive / Active: 27 passive 2 active
Cased based / Aggregated: 28 cased based / 1 aggregated
Case definition: EU 2008 in 19 countries, EU 2002 in 3 countries, other 7
National coverages: 29 countries
2 countries were not able to reconcile laboratory data with notification
IMD notification rates overall and by serogroup, EU\EEA 1999-2011 (n=76 542, serogroup B n=46 127, serogroup C n=12 702)
Missing serogroup n=12 916, all countries reported
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
Cas
es
pe
r 1
00
00
0
Overall
B
C
IMD notification rate by serogroup Y, EU\EEA 1999-2011 (n=1 701)
0.00
0.01
0.02
0.03
0.04
0.05
0.06
0.07
19
99
20
00
20
01
20
02
20
03
20
04
20
05
20
06
20
07
20
08
20
09
20
10
20
11
Cas
es
pe
r 1
00
00
0
Missing serogroup n=12916/76542, all countries reported
IMD notification rate by age group, EU\EEA 1999-2011 (n=75 677)
Missing age n=865, all countries reported
IMD notification rate by serogroup C and implementation of the immunisation strategies in countries with consistent reporting, 1999-2009 (n=9,659)
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
1.60
1.80
2.00
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Ca
se
s p
er
10
0 0
00
Without universalvaccination
With universalvaccination
Contributing countries varied over time showing whether or not the country had a vaccination programme in a given year
Austria, Czech Republic, Denmark, Estonia, France, Greece, Iceland, Ireland, Italy, Malta, the Netherlands, Norway, Slovenia, Spain, Sweden, and United Kingdom.
IMD notification rate by country, EU\EEA 2011 (N 4582)
IMD circulating serogroups, EU /EEA 2011 (n=3 853)
Missing serogroup n=729
Proportion of cases by age group and serogroup, EU/EEA 2011 (n=3 840)
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0 yr 1-4 yr 5-14 yr 15-24 yr 25-49 yr 50-64 yr 65-100 yr
Other
Y
C
B
Missing serogroup or age n=742
Clinical presentation of IMD, EU/EEA 2011 (n=2 445)
39%
15% 31%
15%
Meningitidis
Meningitidis and Septicemia
Septicemia
Other
Missing clinical presentation n=2137
Proportion of cases due to serogroup C by age group and vaccination status, EU/EEA 2011 (n=153)
Missing age and/or vaccination status n=83
Limitations
Under – ascertainment could have lead to underestimate the true burden of the disease as passive routine surveillance systems are prone to under reporting
Case ascertainment may vary considerably between countries: e.g. surveillance system may collect information only on certain clinical presentation, different case definition are applied
Non-differential misclassification may concern clinical presentations and vaccination status as information is not always available when a case is reported by laboratories
Non-differential misclassification of vaccination status may occur as data are not generally reconciled with vaccination registries
Conclusions I
Rare disease but 76 542 cases reported 1999- 2011
A decreasing trend of IMD is observed
MCC vaccine were introduce in several EU\EEA countries likely to be related to the reduction of IMD due to serogroup C
A decreasing trend is observed for serogroup B
The burden of IMD due to serogroup Y is increasing over time
Children below 1 year of age are the most affected
Conclusion II
In 2011
– 4 502 cases
– The highest proportion of cases due to serogroup B
– 11% of cases, due to serogroup C, could have been prevented by vaccination (assuming vaccine effectiveness 80%)
– 40% affected by meningitidis
– 343 deaths
Conclusions III
Surveillance at EU level need to be strengthened in order to monitor serogroup replacement and emergence of new virulent strains
More accurate information need to be collected in MS to estimate the number of cases among vaccinated individuals (n. of vaccine failures)
THANKS IBD ECDC team Dora Navarro Torne (adoracion.navarrotorne@ecdc.europa.eu) Ida Czumbel (ida.czumbel@ecdc.europa.eu) Lucia Pastore Celentano (lucia.pastore.celentano@ecdc.europa.eu) Marta Busana (marta.busana@ecdc.europa.eu) Silvia Sarbu and Adrian Prodan (tessy@ecdc.europa.eu) Country experts National experts for their contribution to IMD Network
THANK YOU FOR YOUR ATTENTION!
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