Variable clinical presentation by the main capsular groups causing invasive meningococcal disease in England

Area of Science:

• Epidemiology
• Infectious Diseases
• Public Health

Background:

• Invasive meningococcal disease (IMD) commonly presents as meningitis or septicaemia.
• Atypical clinical presentations of IMD are rare but documented.
• Understanding these variations is crucial for timely diagnosis and management.

Purpose of the Study:

• To investigate the relationship between meningococcal capsular groups (MenB, MenW, MenY), patient age, and clinical presentation in England.
• To analyze diagnostic patterns and outcomes of IMD cases in 2014.
• To identify associations between specific meningococcal groups, age, and clinical manifestations.

Main Methods:

• Utilized enhanced national surveillance data for laboratory-confirmed IMD cases (MenB, MenW, MenY) in individuals aged 5 years and older in England (2014).
• Classified presenting symptoms, diagnoses, and outcomes.
• Employed multivariable logistic regression to assess independent associations between capsular group, clinical presentation, gender, age, and mortality.

Main Results:

• In 2014, 340 IMD cases were recorded: MenB (179), MenW (95), MenY (66).
• Meningitis was more common in MenB cases and 15-24 year-olds; bacteraemic pneumonia was prevalent in MenY cases and ≥65 year-olds.
• Gastrointestinal and upper respiratory tract symptoms were noted in a significant proportion of cases, varying by capsular group and age; increasing age correlated with bacteraemic pneumonia.

Conclusions:

• Atypical clinical presentations of IMD are associated with specific meningococcal capsular groups and age demographics.
• Healthcare professionals must be aware of these variations to effectively diagnose and manage IMD.
• Enhanced awareness of atypical presentations across different age groups and serogroups can improve patient outcomes.