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Recent increased incidence of invasive serogroup W meningococcal disease: A retrospective observational study

Nichlas Hovmand1, Lene Fogt Lundbo2, Gitte Kronborg3

  • 1Center of Research & Disruption of Infectious Diseases (CREDID), Department of Infectious Diseases, Hvidovre Hospital, Kettegaard Alle 30, 2650 Hvidovre, Denmark; Faculty of Human Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|June 8, 2021
PubMed
Abstract

Insights

The incidence of invasive meningococcal disease caused by Neisseria meningitidis serogroup W has risen. However, serogroup W infection does not independently increase the risk of 30-day mortality in patients with invasive meningococcal disease.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Neisseria meningitidis serogroup W (MenW) incidence has increased globally.
  • MenW has historically been associated with higher mortality rates compared to other serogroups.
  • Understanding the epidemiological characteristics and risk factors for poor outcomes in invasive meningococcal disease (IMD) is crucial for public health interventions.

Purpose of the Study:

  • To analyze the epidemiological characteristics of IMD in Denmark from 1980 to 2018.
  • To identify risk factors associated with increased incidence of MenW infections.
  • To assess the risk of poor outcomes, specifically 30-day mortality, in patients with IMD, considering serogroup and other clinical factors.

Main Methods:

  • Analysis of all reported cases of IMD in Denmark between 1980 and 2018.
  • Calculation of incidence rates stratified by age, sex, clinical manifestation, and serogroup.
  • Utilized Poisson regression to examine trends in MenW incidence and multivariate logistic regression to identify mortality risk factors.

Main Results:

  • A total of 5,825 IMD cases were analyzed.
  • The risk of MenW infection significantly increased after 2015 compared to previous periods.
  • While crude case fatality rates varied by serogroup (W: 12.0%, Y: 11.9%, C: 9.2%, B: 7.9%), adjusted 30-day mortality was comparable across serogroups. Older age (≥60 years) and sepsis were independent predictors of death.

Conclusions:

  • Invasive meningococcal disease caused by serogroup W has shown an increasing trend in Denmark.
  • Despite the rise in MenW, the serogroup itself was not found to be an independent risk factor for increased 30-day mortality.
  • Older age and the presence of sepsis are significant independent predictors of mortality in patients with IMD.
Keywords:
DenmarkMortalityNeisseria meningitidisSerogroup W

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