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Abstract

In 2015 an increased incidence of invasive meningococcal disease due to serogroup-C (MenC) occurred in Tuscany, Italy. This led the Regional Health Authority of Tuscany to implement a reactive immunisation campaign and to launch an epidemiological field investigation aiming to address targeted immunisation interventions. In 2011–14, 10 MenC cases had been reported compared with 62 cases in 2015–16. The case fatality rate was 21% (n = 13) and 51 cases (82.3%) were confirmed as C:P1.5–1,10–8:F3–6:ST-11(cc11). Overall, 17 clusters were recognised. Six discos and four gay-venues were found to have a role as transmission-hotspots, having been attended by 20 and 14 cases in the 10 days before symptoms onset. Ten and three cases occurred, respectively, among men who have sex with men (MSM) and bisexual individuals, who were involved in 11 clusters. In addition, heterosexual cases (n = 5) attending gay-venues were also found. Secondary cases were not identified. Molecular typing indicated close relationship with MenC clusters recently described among gay, bisexual and other MSM in Europe and the United States, suggesting a possible international spread of the serogroup-C-variant P1.5–1,10–8:F3–6:ST-11(cc11) in this population-group; however, epidemiological links were not identified. In December 2016, a targeted vaccination campaign involving discos and lesbian, gay, bisexual, and transgender (LGBT) associations was implemented. During 2017, 10 cases of MenC occurred, compared with 32 and 30 cases reported in 2015 and 2016 respectively, suggesting the effectiveness of the reactive and targeted immunisation programmes.

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2018-08-23
2024-12-03
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2018.23.34.1700636
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References

  1. Trotter CL, Gay NJ, Edmunds WJ. The natural history of meningococcal carriage and disease. Epidemiol Infect. 2006;134(3):556-66.  https://doi.org/10.1017/S0950268805005339  PMID: 16238823 
  2. Harrison OB, Claus H, Jiang Y, Bennett JS, Bratcher HB, Jolley KA, et al. Description and nomenclature of Neisseria meningitidis capsule locus. Emerg Infect Dis. 2013;19(4):566-73.  https://doi.org/10.3201/eid1904.111799  PMID: 23628376 
  3. European Centre for Disease Prevention and Control (ECDC). Annual Epidemiological Report 2016 – Invasive meningococcal disease. Stockholm: ECDC; 2016. Available from: https://ecdc.europa.eu/sites/portal/files/documents/Invasive%20meningococcal%20disease%20AER.pdf
  4. Istituto Superiore di Sanità. Annual surveillance report of invasive bacterial diseases. December 2016. Rome, Italy. Available from: http://www.iss.it/binary/mabi/cont/Report_MBI_20161116_v11.pdf
  5. Azzari C, Nieddu F, Moriondo M, Indolfi G, Canessa C, Ricci S, et al. Underestimation of Invasive Meningococcal Disease in Italy. Emerg Infect Dis. 2016;22(3):469-75.  https://doi.org/10.3201/eid2203.150928  PMID: 26890305 
  6. Stefanelli P, Miglietta A, Pezzotti P, Fazio C, Neri A, Vacca P, et al. Increased incidence of invasive meningococcal disease of serogroup C / clonal complex 11, Tuscany, Italy, 2015 to 2016. Euro Surveill. 2016;21(12):30176.  https://doi.org/10.2807/1560-7917.ES.2016.21.12.30176  PMID: 27035155 
  7. Marcus U, Vogel U, Schubert A, Claus H, Baetzing-Feigenbaum J, Hellenbrand W, et al. A cluster of invasive meningococcal disease in young men who have sex with men in Berlin, October 2012 to May 2013. Euro Surveill. 2013;18(28):20523.  https://doi.org/10.2807/1560-7917.ES2013.18.28.20523  PMID: 23870095 
  8. Aubert L, Taha M, Boo N, Le Strat Y, Deghmane AE, Sanna A, et al. Serogroup C invasive meningococcal disease among men who have sex with men and in gay-oriented social venues in the Paris region: July 2013 to December 2014. Euro Surveill. 2015;20(3):21016.  https://doi.org/10.2807/1560-7917.ES2015.20.3.21016  PMID: 25635319 
  9. Weiss D, Varma JK. Control of recent community-based outbreaks of invasive meningococcal disease in men who have sex with men in Europe and the United States. Euro Surveill. 2013;18(28):20522.  https://doi.org/10.2807/1560-7917.ES2013.18.28.20522  PMID: 23870094 
  10. Koch J, Hellenbrand W, Schink S, Wichmann O, Carganico A, Drewes J, et al. Evaluation of a temporary vaccination recommendation in response to an outbreak of invasive meningococcal serogroup C disease in men who have sex with men in Berlin, 2013-2014. Euro Surveill. 2016;21(5):30122.  https://doi.org/10.2807/1560-7917.ES.2016.21.5.30122  PMID: 26877165 
  11. European Centre for Disease Prevention and Control (ECDC). Invasive meningococcal disease among men who have sex with men. Rapid risk assessment. Stockholm: ECDC; 3 July 2013. Available from: http://ecdc.europa.eu/en/publications/Publications/rapid-risk-assessment-invasive-meningococcal-disease-among-MSM.pdf
  12. Ministero della Salute. Cluster di malattia meningococcica invasiva in MSM in Europa [invasive meningococcal disease among MSM in Europe]. Rome: Ministero della Salute; 2 August 2013. Circolare del Ministero della Salute (DGPRE/0017800-P-02/08/2013). Italian. Available from: http://www.vaccinarsi.org/assets/uploads/files/147/circ_ministero_salute_n17800_02.08.2013.pdf
  13. Stefanelli P, Fazio C, Neri A, Isola P, Sani S, Marelli P, et al. Cluster of invasive Neisseria meningitidis infections on a cruise ship, Italy, October 2012. Euro Surveill. 2012;17(50):20336. PMID: 23241233 
  14. Fazio C, Neri A, Tonino S, Carannante A, Caporali MG, Salmaso S, et al. Characterisation of Neisseria meningitidis C strains causing two clusters in the north of Italy in 2007 and 2008. Euro Surveill. 2009;14(16):19179. PMID: 19389338 
  15. Official Journal of the European Union 18.6.2008 L 159/65.COMMISSION DECISION of 28 April 2008 amending Decision 2002/253/EC laying down case definitions for reporting communicable diseases to the Community network under Decision No 2119/98/EC of the European Parliament and of the Council (reference number C(2008) 1589) 2008/427/EC. Available from: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2008:159:0046:0090:EN:PDF
  16. MacNeil J, Cohn A. Chapter 8: Meningococcal Disease. In: VPD surveillance manual 5th ed. Atlanta: Centers for Disease Control and Prevention; 2008. Available from: https://www.cdc.gov/vaccines/pubs/surv-manual/chpt08-mening.pdf
  17. Vogel U, Claus H, Frosch M, Caugant DA. Molecular basis for distinction of the ET-15 clone within the ET-37 complex of Neisseria meningitidis. J Clin Microbiol. 2000;38(2):941-2. PMID: 10722324 
  18. Stefanelli P, Fazio C, Neri A, Ciammaruconi A, Balocchini E, Anselmo A, et al. Genome-based study of a spatio-temporal cluster of invasive meningococcal disease due to Neisseria meningitidis serogroup C, clonal complex 11. J Infect. 2016;73(2):136-44.  https://doi.org/10.1016/j.jinf.2016.05.003  PMID: 27235364 
  19. European Centre for Disease Prevention and Control (ECDC). Public health management of sporadic cases of invasive meningococcal disease and their contacts. Stockholm: ECDC; 2010. Available from: http://ecdc.europa.eu/en/publications/Publications/1010_GUI_Meningococcal_guidance.pdf
  20. Imrey PB, Jackson LA, Ludwinski PH, England AC 3rd, Fella GA, Fox BC, et al. Meningococcal carriage, alcohol consumption, and campus bar patronage in a serogroup C meningococcal disease outbreak. J Clin Microbiol. 1995;33(12):3133-7. PMID: 8586688 
  21. Bruce MG, Rosenstein NE, Capparella JM, Shutt KA, Perkins BA, Collins M. Risk factors for meningococcal disease in college students. JAMA. 2001;286(6):688-93.  https://doi.org/10.1001/jama.286.6.688  PMID: 11495618 
  22. Coen PG, Tully J, Stuart JM, Ashby D, Viner RM, Booy R. Is it exposure to cigarette smoke or to smokers which increases the risk of meningococcal disease in teenagers? Int J Epidemiol. 2006;35(2):330-6.  https://doi.org/10.1093/ije/dyi295  PMID: 16394119 
  23. Murray RL, Britton J, Leonardi-Bee J. Second hand smoke exposure and the risk of invasive meningococcal disease in children: systematic review and meta-analysis. BMC Public Health. 2012;12:1062.  https://doi.org/10.1186/1471-2458-12-1062  PMID: 23228219 
  24. Ridpath A, Greene SK, Robinson BF, Weiss DMeningococcal Investigation Team. Risk Factors for Serogroup C Meningococcal Disease during Outbreak among Men who Have Sex with Men, New York City, New York, USA. Emerg Infect Dis. 2015;21(8):1458-61.  https://doi.org/10.3201/eid2108.141932  PMID: 26196855 
  25. Neisseria.org. [Accessed May 2016]. Available from: http://neisseria.org/
  26. Page NSTH. [Accessed May 2016]. Available from: http://pubmlst.org/neisseria/
  27. Smith CM, Le Comber SC, Fry H, Bull M, Leach S, Hayward AC. Spatial methods for infectious disease outbreak investigations: systematic literature review. Euro Surveill. 2015;20(39):30026.  https://doi.org/10.2807/1560-7917.ES.2015.20.39.30026  PMID: 26536896 
  28. Italian National Institute of Statistics (ISTAT). Demografia in cifre. Popolazione residente, Toscana, anno 2015. [Demography in figures. Resident population of Tuscany, year 2015]. ISTAT: Rome. Italian. Available from: http://demo.istat.it/index_e.html
  29. Janda WM, Bohnoff M, Morello JA, Lerner SA. Prevalence and site-pathogen studies of Neisseria meningitidis and N gonorrhoeae in homosexual men. JAMA. 1980;244(18):2060-4.  https://doi.org/10.1001/jama.1980.03310180026026  PMID: 6776296 
  30. Toh E, Gangaiah D, Batteiger BE, Williams JA, Arno JN, Tai A, et al. Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015-2016. Emerg Infect Dis. 2017;23(2):336-9.  https://doi.org/10.3201/eid2302.161434  PMID: 28098538 
  31. Folaranmi TA, Kretz CB, Kamiya H, MacNeil JR, Whaley MJ, Blain A, et al. Increased Risk for Meningococcal Disease Among Men Who Have Sex With Men in the United States, 2012-2015. Clin Infect Dis. 2017;65(5):756-63.  https://doi.org/10.1093/cid/cix438  PMID: 28505234 
  32. Bell AV, Ompad D, Sherman SG. Sexual and drug risk behaviors among women who have sex with women. Am J Public Health. 2006;96(6):1066-72.  https://doi.org/10.2105/AJPH.2004.061077  PMID: 16670234 
  33. US Centers for Disease Prevention and Control (CDC). Lesbian, Gay, Bisexual, and Transgender Health. Atlanta:CDC; Available from: https://www.cdc.gov/lgbthealth/about.htm
  34. Hao W, Ma JH, Warren K, Tsang RS, Low DE, Jamieson FB, et al. Extensive genomic variation within clonal complexes of Neisseria meningitidis. Genome Biol Evol. 2011;3(4):1406-18.  https://doi.org/10.1093/gbe/evr119  PMID: 22084315 
  35. Hauri AM, Ehrhard I, Frank U, Ammer J, Fell G, Hamouda O, et al. Serogroup C meningococcal disease outbreak associated with discotheque attendance during carnival. Epidemiol Infect. 2000;124(1):69-73.  https://doi.org/10.1017/S0950268899003416  PMID: 10722132 
  36. Riesbeck K, Orvelid-Mölling P, Fredlund H, Olcén P. Long-term persistence of a discotheque-associated invasive Neisseria meningitidis group C strain as proven by pulsed-field gel electrophoresis and porA gene sequencing. J Clin Microbiol. 2000;38(4):1638-40. PMID: 10747157 
  37. Zangwill KM, Schuchat A, Riedo FX, Pinner RW, Koo DT, Reeves MW, et al. School-based clusters of meningococcal disease in the United States. Descriptive epidemiology and a case-control analysis. JAMA. 1997;277(5):389-95.  https://doi.org/10.1001/jama.1997.03540290041030  PMID: 9010171 
  38. Puleston R, Beck C, Tahir M, Bardhan M, Charlemagne P, Alves C, et al. An unusual transmission event of Neisseria meningitidis serogroup W135 type 2a in a healthcare setting, England, 2012. Euro Surveill. 2012;17(44):20308.  PMID: 23137486 
Interconnected clusters of invasive meningococcal disease due to Neisseria meningitidis serogroup C ST-11 (cc11), involving bisexuals and men who have sex with men, with discos and gay-venues hotspots of transmission, Tuscany, Italy, 2015 to 2016
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Alessandro+Miglietta&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Miglietta Alessandro</a>, <a href="/search?value1=Cecilia+Fazio&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fazio Cecilia</a>, <a href="/search?value1=Arianna+Neri&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Neri Arianna</a>, <a href="/search?value1=Patrizio+Pezzotti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pezzotti Patrizio</a>, <a href="/search?value1=Francesco+Innocenti&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Innocenti Francesco</a>, <a href="/search?value1=Chiara+Azzari&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Azzari Chiara</a>, <a href="/search?value1=Gian+Maria+Rossolini&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rossolini Gian Maria</a>, <a href="/search?value1=Maria+Moriondo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Moriondo Maria</a>, <a href="/search?value1=Francesco+Nieddu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Nieddu Francesco</a>, <a href="/search?value1=Stefania+Iannazzo&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Iannazzo Stefania</a>, <a href="/search?value1=Fortunato+D%E2%80%99Ancona&option1=author&noRedirect=true" class="nonDisambigAuthorLink">D’Ancona Fortunato</a>, <a href="/search?value1=Francesco+Paolo+Maraglino&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Maraglino Francesco Paolo</a>, <a href="/search?value1=Raniero+Guerra&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Guerra Raniero</a>, <a href="/search?value1=Giovanni+Rezza&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Rezza Giovanni</a>, <a href="/search?value1=Fabio+Voller&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Voller Fabio</a>, <a href="/search?value1=Paola+Stefanelli&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stefanelli Paola</a></span>. Interconnected clusters of invasive meningococcal disease due to Neisseria meningitidis serogroup C ST-11 (cc11), involving bisexuals and men who have sex with men, with discos and gay-venues hotspots of transmission, Tuscany, Italy, 2015 to 2016. <a href="/content/ecdc">Euro Surveill.</a> 2018;23(34):pii=1700636. <a href="https://doi.org/10.2807/1560-7917.ES.2018.23.34.1700636" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2018.23.34.1700636</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 14 Sept 2017;&nbsp;&nbsp; <span class="generated">Accepted</span>: 22 Mar 2018 </span> </p>
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    • Molecular characteristics of the serogroup C Neisseria meningitidis derived from meningococcal disease cases, Tuscany, Italy, 2015–2016

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