Epidemiology of invasive meningococcal disease in Greece, 2006–2016
The present study describes the epidemiology of invasive meningococcal disease (IMD) in Greece for the period 2006–2016. Combined data from notified and laboratory-confirmed IMD cases were obtained from the two involved National Centres (Epidemiology and Reference Laboratory). Laboratory identification and typing was carried out by both conventional (culture) and molecular methods (PCR, MLST, PorA, and FetA typing). A total of 796 IMD cases were notified; of those, 720 (91%) were laboratory confirmed. Overall, a decline on the annual incidence of confirmed cases was observed, ranging from 0.91 (2006) to 0.47 (2016) /100,000. A similar trend was observed in most age groups especially in children 0–4 years (7.7 to 2.9/100,000), with the exception of an increase in the incidence rate in adults > 20 years (0.21 to 0.32/100,000). The overall case fatality rate was 6.5% (52/796), annual range 2–13%. Among 658 strains which were typed by sero/genogroup, 80% were identified as MenB (annual range 65–92%); however, a decline was observed in MenB incidence from 5.3 (2006) to 2.7 (2016), among infants and toddlers, while MenW (1%), MenY (2%), and MenA (1%) remained low. During the 11 years, the annual incidence of IMD declined by 50%, especially in the 0–4-year age group, due mainly to MenB. Continuous surveillance of IMD is important for the development of future vaccination and public health policies.
KeywordsInvasive meningococcal disease (IMD) Epidemiology Clonal complex porA fetA Antimicrobial susceptibility
The authors would like to thank Prof Aftab Jasir for critical reviewing and colleagues from hospitals all over Greece for sending samples.
Partial data have been presented previously at the ESCAIDE 2018-European Scientific Conference on Applied Infectious Disease Epidemiology (Malta, 21–23 Nov 2018).
Anastasia Flountzi (AF) analysis and interpretation of data, drafting of manuscript. Theano Georgakopoulou (TG) acquisition of data, analysis and interpretation of data, critical revision. Sooria Balasegaram (SB) analysis and interpretation of data, drafting of manuscript. Konstantinos Kesanopoulos (KK) acquisition of data. Athanasia Xirogianni (AX) acquisition of data. Anastasia Papandreou (AP) acquisition of data. Georgina Tzanakaki (GT) study conception and design, acquisition of data, critical revision.
Compliance with ethical standards
Ethic approval was not required since depersonalized data from notifiable disease registry and laboratory findings were used.
Conflict of interest
The authors declare that they have no conflict of interest.
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