TY - JOUR
T1 - The burden of invasive meningococcal disease in the Netherlands, 2011–2020
AU - Middeldorp, Marit
AU - Steens, Anneke
AU - Lagerweij, Giske
AU - van Sorge, Nina M.
AU - Freudenburg-de Graaf, Wieke
AU - A. M. Sanders, Elisabeth
AU - de Melker, Hester E.
AU - Knol, Mirjam J.
N1 - Funding Information: This work was supported by the Dutch Ministry of Health, Welfare and Sports. Publisher Copyright: © 2023 The Authors
PY - 2023/4/17
Y1 - 2023/4/17
N2 - Introduction: Representative information on disease course and outcome of invasive meningococcal disease (IMD) is important because of the shift in meningococcal epidemiology that recently occurred in the Netherlands. With this study, we update earlier research on the burden of IMD in the Netherlands. Material and methods: We performed a retrospective study using Dutch surveillance data on IMD from July 2011 to May 2020. Clinical information was collected from hospital records. The effect of age, serogroup, and clinical manifestation on disease course and outcome was assessed in multivariable logistic regression analyses. Grouping of infecting isolates was performed by Ouchterlony gel diffusion or by PCR. Results: Clinical information was collected for 278 IMD cases of which the majority had IMD-B (55%), followed by IMD-W (27%), IMD-Y (13%), and IMD-C (5%). Most patients presented with meningitis (32%) or sepsis (30%). Hospitalisation for ≥ 10 days was most frequent among 24–64 year olds (67%). ICU admission was highest among 24–64 year olds (60%), and in case of sepsis (70%), or sepsis plus meningitis (61%). Sequelae at discharge was lower for patients with mild meningococcaemia compared to patients with sepsis plus meningitis (OR: 0.19, 95% CI: 0.07–0.51). The overall case fatality rate was 7%, and was highest for IMD-Y (14%) and IMD-W (13%) patients. Conclusions: IMD remains a disease with high morbidity and mortality. Sepsis (with or without meningitis) is associated with a more severe disease course and outcome compared to other clinical manifestations. The high disease burden can be partly prevented by meningococcal vaccination.
AB - Introduction: Representative information on disease course and outcome of invasive meningococcal disease (IMD) is important because of the shift in meningococcal epidemiology that recently occurred in the Netherlands. With this study, we update earlier research on the burden of IMD in the Netherlands. Material and methods: We performed a retrospective study using Dutch surveillance data on IMD from July 2011 to May 2020. Clinical information was collected from hospital records. The effect of age, serogroup, and clinical manifestation on disease course and outcome was assessed in multivariable logistic regression analyses. Grouping of infecting isolates was performed by Ouchterlony gel diffusion or by PCR. Results: Clinical information was collected for 278 IMD cases of which the majority had IMD-B (55%), followed by IMD-W (27%), IMD-Y (13%), and IMD-C (5%). Most patients presented with meningitis (32%) or sepsis (30%). Hospitalisation for ≥ 10 days was most frequent among 24–64 year olds (67%). ICU admission was highest among 24–64 year olds (60%), and in case of sepsis (70%), or sepsis plus meningitis (61%). Sequelae at discharge was lower for patients with mild meningococcaemia compared to patients with sepsis plus meningitis (OR: 0.19, 95% CI: 0.07–0.51). The overall case fatality rate was 7%, and was highest for IMD-Y (14%) and IMD-W (13%) patients. Conclusions: IMD remains a disease with high morbidity and mortality. Sepsis (with or without meningitis) is associated with a more severe disease course and outcome compared to other clinical manifestations. The high disease burden can be partly prevented by meningococcal vaccination.
KW - Case-fatality
KW - Disease course
KW - Invasive meningococcal disease
KW - Sequelae
KW - Serogroup
UR - http://www.scopus.com/inward/record.url?scp=85150247878&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.vaccine.2023.03.017
DO - https://doi.org/10.1016/j.vaccine.2023.03.017
M3 - Article
C2 - 36933982
SN - 0264-410X
VL - 41
SP - 2664
EP - 2670
JO - Vaccine
JF - Vaccine
IS - 16
ER -