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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

Invasive meningococcal disease, Surveillance

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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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Page 1: Invasive meningococcal disease, Surveillance

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

Page 2: Invasive meningococcal disease, Surveillance

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

Page 3: Invasive meningococcal disease, Surveillance

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

Page 4: Invasive meningococcal disease, Surveillance

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

Page 5: Invasive meningococcal disease, Surveillance

IMD notification rate by age group, EU\EEA 1999-2011 (n=75 677)

Missing age n=865, all countries reported

Page 6: Invasive meningococcal disease, Surveillance

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.

Page 7: Invasive meningococcal disease, Surveillance

IMD notification rate by country, EU\EEA 2011 (N 4582)

Page 8: Invasive meningococcal disease, Surveillance

IMD circulating serogroups, EU /EEA 2011 (n=3 853)

Missing serogroup n=729

Page 9: Invasive meningococcal disease, Surveillance

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

Page 10: Invasive meningococcal disease, Surveillance

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

Page 11: Invasive meningococcal disease, Surveillance

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

Page 12: Invasive meningococcal disease, Surveillance

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

Page 13: Invasive meningococcal disease, Surveillance

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

Page 14: Invasive meningococcal disease, Surveillance

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

Page 15: Invasive meningococcal disease, Surveillance

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)

Page 16: Invasive meningococcal disease, Surveillance

THANKS IBD ECDC team Dora Navarro Torne ([email protected]) Ida Czumbel ([email protected]) Lucia Pastore Celentano ([email protected]) Marta Busana ([email protected]) Silvia Sarbu and Adrian Prodan ([email protected]) Country experts National experts for their contribution to IMD Network

THANK YOU FOR YOUR ATTENTION!