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Australian Meningococcal Surveillance Programme annual report, 2017.
Monica M Lahra1, Rodney P Enriquez2, C R Robert George2
1The National Neisseria Network, Australia; Neisseria Reference Laboratory and World Health Organisation Collaborating Centre for STD, Sydney; New South Wales Health Pathology, Microbiology, The Prince of Wales Hospital, Randwick, NSW Australia;School of Medical Sciences, Faculty of Medicine, The University of New South Wales, 2053 Australia.
Communicable Diseases Intelligence (2018)
|December 17, 2019
Summary
Invasive meningococcal disease (IMD) cases in Australia reached a 14-year high in 2017, with serogroup W and Y infections at record levels. Serogroup B remained prevalent in younger individuals, while W and Y strains showed distinct age distributions.
Area of Science:
- Public Health and Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Invasive meningococcal disease (IMD) is a significant public health concern in Australia.
- Surveillance data is crucial for understanding trends and guiding public health interventions.
- 2017 marked a notable increase in reported IMD cases.
Purpose of the Study:
- To analyze the epidemiological and microbiological characteristics of laboratory-confirmed IMD cases in Australia in 2017.
- To identify trends in serogroup distribution, age-specific incidence, and antimicrobial resistance patterns.
- To compare findings with historical data and circulating international strains.
Main Methods:
- Analysis of 374 laboratory-confirmed IMD cases reported to the Australian National Neisseria Network in 2017.
- Serogroup determination for 98% of cases.
- Molecular typing (genotyping) of strains, including PorA and sequence typing for serogroup W isolates.
- Antimicrobial susceptibility testing for penicillin, ceftriaxone, ciprofloxacin, and rifampicin.
Main Results:
- A total of 374 laboratory-confirmed IMD cases were reported, the highest since 2003.
- Serogroup B (37%) and W (38%) were the most common, with serogroup W reaching record high numbers.
- Serogroup Y also showed a record high proportion (20%).
- Serogroup W strains predominantly belonged to sequence type 11, consistent with hypervirulent international strains.
- Primary IMD peak was in adults aged 45+, with secondary peaks in children <5 years.
- Serogroup B predominated in 15-19 year olds, W in those aged 65+, and Y in adults aged 45+.
- 5.1% of isolates were resistant to penicillin, with decreased susceptibility in 89%; all isolates were susceptible to ceftriaxone.
Conclusions:
- 2017 saw a significant increase in IMD cases in Australia, driven by serogroups W and Y.
- The genetic characteristics of serogroup W strains suggest ongoing transmission of hypervirulent clones.
- Age distribution varied by serogroup, highlighting the need for targeted prevention strategies.
- Emerging antimicrobial resistance, particularly to penicillin, warrants continued monitoring.
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