Invasive Meningococcal Capsular Group Y Disease, England and Wales, 2007–2009

Shamez N Ladhani,Raymond Borrow,Jay Lucidarme,Jamie Findlow,Stephen J Gray,Lynne S Newbold,Edward B Kaczmarski,Mary E Ramsay,Anthony D Carr

doi:10.3201/eid1801.110901

Abstract

Enhanced national surveillance for invasive meningococcal disease in England and Wales identified an increase in laboratory-confirmed capsular group Y (MenY) disease from 34 cases in 2007 to 44 in 2008 and 65 in 2009. For cases diagnosed in 2009, patient median age at disease onset was 60 years; 39% of patients had underlying medical conditions, and 19% died. MenY isolates causing invasive disease during 2007-2009 belonged mainly to 1 of 4 clonal complexes (cc), cc23 (56% of isolates), cc174 (21%), cc167 (11%), and cc22 (8%). The 2009 increase resulted primarily from sequence type 1655 (cc23) (22 cases in 2009, compared with 4 cases each in 2007 and 2008). cc23 was associated with lpxL1 mutations and meningitis in younger age groups (<25 years); cc174 was associated with nonmeningitis, particularly pneumonia, in older age groups (>65 years). The increase in MenY disease requires careful epidemiologic and molecular monitoring.

Highlights

ABCs Areas California (3 county San Francisco Bay area); Colorado (5 county Denver area); Connecticut; Georgia; Maryland; Minnesota; New Mexico; New York (15 county Rochester and Albany areas); Oregon; Tennessee (11 urban counties)
For national estimates of cases, race- and age-specific rates of disease were applied from the aggregate surveillance area to the age and racial distribution of the 2009 U.S population for 49 states
Cases with unknown race were distributed by area

Summary

Introduction

ABCs Areas California (3 county San Francisco Bay area); Colorado (5 county Denver area); Connecticut; Georgia; Maryland; Minnesota; New Mexico; New York (15 county Rochester and Albany areas); Oregon; Tennessee (11 urban counties). ABCs Population The surveillance areas represent 41,261,719 persons. ABCs Case Definition Invasive meningococcal disease: isolation of Neisseria meningitidis from normally sterile site in a resident of a surveillance area in 2009. ABCs Methodology ABCs personnel routinely contacted all microbiology laboratories serving acute care hospitals in their area to identify cases.

Results

Conclusion