Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/22608
Title: Clinical manifestations of invasive meningococcal disease in Victoria with the emergence of serogroup W and serogroup Y Neisseria meningitidis.
Authors: Birrell, Michael T;Strachan, Janet;Holmes, Natasha E;Stevens, Kerrie;Howden, Benjamin P;Franklin, Lucinda J;Ivan, Mihaela;Kwong, Jason C
Affiliation: Reference, Unusual Pathogens and Resistance Section Leader, Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne, Parkville, Victoria, Australia
Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne, Parkville, Victoria, Australia
Public Health Physician, Department of Health and Human Services, Melbourne, Victoria, Australia
Principal Epidemiologist, Department of Health and Human Services, Melbourne, Victoria, Australia
Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Department of Health and Human Services, Melbourne, Victoria, Australia
Infectious Diseases Physician, Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Director, Microbiological Diagnostic Unit Public Health Laboratory, University of Melbourne, Parkville, Victoria, Australia
Issue Date: 11-Feb-2020
EDate: 2020-02-11
Citation: Internal Medicine Journal 2020; online first: 11 February
Abstract: Historically, Australian cases of invasive meningococcal disease (IMD) have been most frequently caused by Neisseria meningitidis serogroup-B, but recently an increase in cases due to serogroup-W (MenW) and serogroup-Y (MenY) has occurred. To determine whether clinical manifestations of IMD have changed due to increased incidence of MenW and MenY. We performed a retrospective review of IMD cases notified to the Department of Health and Human Services in Victoria, Australia. We compared the period between January 2013 and June 2015 (defined as P1) immediately before the increase in MenW and MenY was noted, with the equal time period of July 2015 to December 2017 (P2), when this increase was observed. IMD was notified more frequently in P2 than P1 (1.24 vs 0.53 per 100 000 person-years; p < 0.001). IMD cases in P2 were older (46 vs 19 years; p < 0.001), and more likely due to MenW (92/187, 49.2% vs 11/80, 13.8%, p < 0.001) or MenY (31/187, 16.6% vs 4/80, 5.0%, p = 0.01). IMD cases from P2 were more likely bacteraemic (151/187, 80.7% vs 55/80, 68.8%, p = 0.04), while meningitis (68/187, 36.4% vs 41/80, 51.3%, p = 0.03) and rash (65/181, 35.9% vs 45/78, 57.7%, p = 0.002) were less frequent. ICU admission rates and in-hospital mortality were unchanged. Alongside an increase in IMD in Victoria, the proliferation of cases of MenW and MenY occurred in older patients, and were more often identified through bacteraemia rather than meningitis or purpura fulminans. Clinicians should be aware of these changes to facilitate earlier identification and treatment of IMD. This article is protected by copyright. All rights reserved.
URI: http://ahro.austin.org.au/austinjspui/handle/1/22608
DOI: 10.1111/imj.14771
ORCID: 0000-0002-4480-4911
PubMed URL: 32043702
Type: Journal Article
Subjects: Bacteria
Neisseria meningitidis
Victoria
epidemiology
invasive meningococcal disease
meningococcal serogroup W disease
Appears in Collections:Journal articles

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