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Australian Meningococcal Surveillance Programme annual report, 2014
Monica M Lahra1,2, Rodney P Enriquez1
1WHO Collaborating Centre for STD and Neisseria Reference Laboratory, Microbiology Department, South Eastern Area Laboratory Services, the Prince of Wales Hospital, Sydney, New South Wales.
Abstract:
In 2014 there were 165 laboratory-confirmed cases of invasive meningococcal disease analysed by the Australian National Neisseria Network. This number was higher than the number reported in 2013, but was the second lowest reported since inception of the Australian Meningococcal Surveillance Programme in 1994. Probable and laboratory confirmed invasive meningococcal disease (IMD) are notifiable in Australia, and there were 170 IMD cases notified to the National Notifiable Diseases Surveillance System (NNDSS) in 2014. This was also higher than in 2013, but was the second lowest number of IMD cases reported to the NNDSS. The meningococcal serogroup was determined for 161/165 (98%) of laboratory confirmed IMD cases. Of these, 80.1% (129 cases) were serogroup B infections; 1.9% (3 cases) were serogroup C infections; 9.9% (16 cases) were serogroup W135; and 8.1% (13 cases) were serogroup Y. Primary and secondary disease peaks were observed in those aged 4 years or less, and in adolescents (15-19 years) respectively. Serogroup B cases predominated in all jurisdictions and age groups, except for those aged 65 years or over, where serogroups Y and W135 combined predominated. The overall proportion and number of IMD caused by serogroup B was higher than in 2013, but has decreased from previous years. The number of cases of IMD caused by serogroup C was the lowest reported to date. The number of IMD cases caused by serogroup Y was similar to previous years, but the number of IMD cases caused serogroup W135 was higher than in 2013. The proportion of IMD cases caused by serogroups Y and W135 has increased in recent years, whilst the overall number of cases of IMD has decreased. Molecular typing was able to be performed on 106 of the 165 IMD cases. In 2014, the most common porA genotypes circulating in Australia were P1.7-2,4 and P1.22,14. All IMD isolates tested were susceptible to ceftriaxone and ciprofloxacin. There were 2 isolates that were resistant to rifampicin. Decreased susceptibility to penicillin was observed in 88% of isolates.
Insights
Invasive meningococcal disease (IMD) surveillance in Australia showed a slight increase in 2014 but remained near historic lows. Serogroup B predominated, though W135 and Y are increasing, particularly in older adults.
Area of Science:
- Microbiology
- Epidemiology
- Public Health
Background:
- Invasive meningococcal disease (IMD) is a significant public health concern globally.
- Surveillance programs are crucial for monitoring disease trends and informing prevention strategies.
- The Australian Meningococcal Surveillance Programme has collected data since 1994.
Observation:
- In 2014, 165 laboratory-confirmed cases of IMD were reported in Australia, a rise from 2013 but the second lowest since 1994.
- Serogroup B was the most common cause (80.1%), followed by W135 (9.9%) and Y (8.1%).
- Disease peaks occurred in young children (≤4 years) and adolescents (15-19 years).
Findings:
- Serogroup B predominated across most age groups, but serogroups Y and W135 were more common in individuals aged 65 years and over.
- While the overall number of IMD cases decreased, the proportion caused by serogroups Y and W135 has increased.
- Molecular typing identified P1.7-2,4 and P1.22,14 as the most common porA genotypes. All isolates were susceptible to ceftriaxone and ciprofloxacin, with two resistant to rifampicin and 88% showing decreased penicillin susceptibility.
Implications:
- Continued surveillance is essential to track evolving serogroup distribution and antimicrobial resistance patterns.
- The increasing proportion of W135 and Y serogroups may necessitate adjustments in vaccination strategies.
- Understanding genotypic characteristics aids in tracking disease transmission and potential vaccine effectiveness.
