Invasive meningococcal disease in the Netherlands
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1 Invasive meningococcal disease in the Netherlands Mirjam Knol, PhD National Institute for Public Health and the Environment (RIVM) 1
2 Content: 1. Update MenW 2. MenB Mirjam Knol, PhD National Institute for Public Health and the Environment (RIVM) 2
3 Disclosure belangen spreker (potentiële) belangenverstrengeling Geen Voor bijeenkomst mogelijk relevante relaties met bedrijven Sponsoring of onderzoeksgeld Honorarium of andere (financiële) vergoeding Aandeelhouder Andere relatie, namelijk
4 Surveillance of IMD Notifiable disease since 1905 Case definition: clinical symptoms and lab confirmation Clinical information including mortality, clinical presentation and vaccination status Laboratory surveillance since 1959 Netherlands Reference Laboratory for Bacterial Meningitis (AMC/RIVM) Positive CSF or blood isolates or samples (culture and PCR) Serogroup and further subtyping Active linkage between notifications and lab data since 2003 Estimated coverage of >90% 4
5 IMD incidence by serogroup Incidence per 100, B C W Y * 5 * Up to September
6 Incidence by serogroup Incidence per 100, Single 14 mo Catch up 1-18 yrs B C W Y * 6 * Up to September
7 Incidence by serogroup Incidence per 100, B C W Y * 7 * Up to September
8 MenW Number of cases N cases Incidence Incidence per 100, * * Up to September
9 Serogroup distribution 100% 90% 80% 70% Aantal gevallen 60% 50% 40% 30% 20% 10% Other C Y B W 0% * 9 * Up to September
10 MenW Incidence per 100, Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q
11 MenW by age Incidence per 100, * < Total Age group * Up to September 11
12 MenW mortality by age (Oct 2015 Sep 2017) % 100 Number of cases % no yes 40 12% 16% 20 11% 0% 0% Total Age group 12
13 Clinical manifestation MenW (Oct 2015 Sep 2017) 60 53% 50 Number of cases % 17% 10 7% 8% 0 septicaemia meningitis septicaemia and meningitis pneumonia other 13
14 MenACWY vaccination 2 vaccines registered in Europe Nimenrix MenACWY-TT (Pfizer) 6 weeks of age Menveo MenACWY-CRM (GSK) 2 years of age September 2017: Decision Minister of Health Based on advice of expert group Replace MenC at 14 months by MenACWY Introduce MenACWY at years of age (single birth cohort) Individual protection Herd protection through reduction of carriage transmission 14
15 Implementation MenACWY vaccination When? 2 nd quarter of 2018 Who? Adolescents in the year they will turn 13 or 14 years (birth cohort 2004 or 2005) Before the peak of disease incidence and carriage How? Group vaccination Together with HPV? Limited data on interference (Menveo-Gardasil) No show policy Why? Communication plan 15
16 IMD incidence by serogroup Incidence per 100, B C W Y * 16 * Up to September
17 MenB N cases Incidence Number of cases Incidence per 100, * * Up to September
18 MenB by age Incidence per 100, * < Total Age group * Up to September 18
19 MenB and MenW by age 2017 (up to Sept) Incidence per 100, B W < Total Age groups 19
20 MenB mortality by age ( *) 200 4% Number of cases % no yes 60 2% % 0% 4% 5% Total Age group * Up to September 20
21 Summary MenW Rapid increase of hypervirulent MenW strain with high mortality Atypical presentation Similarities UK MenACWY vaccine implementation at 14 months and in adolescents starting from 2018 MenB Stable incidence of MenB with lower mortality In children <5 years still the most dominant serogroup MenB vaccination will be discussed in Health Council in
22 Acknowledgements RIVM Guy Berbers Ingrid Drijfhout Laura Kamp Hester de Melker Nynke Rots Helma Ruijs Lieke Sanders Gerre Vermeulen Hans van Vliet NRLBM Arie van der Ende Lab personnel Public Health England Ray Borrow Helen Campbell Steve Gray Shamez Ladhani Jay Lucidarme Mary Ramsay 22
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