Meningococcal disease in The Netherlands, 1958-1990: a steady increase in the incidence since 1982 partially caused by new serotypes and subtypes of Neisseria meningitidis.
In order to explain a threefold increase in the incidence of meningococcal disease in the Netherlands during the 1980s, we serotyped and subtyped Neisseria meningitidis isolates recovered between 1958 and 1990 from > 3,000 patients with systemic disease. No single strain could be held responsible for the increase. Apart from the newly introduced strain B:4:P1.4, which became the most prevalent phenotype in 1990 (21% of all isolates), the majority of the cases in 1990 were caused by many different strains that were already present in the Netherlands before 1980. For the period 1980-1990, a shift in the age distribution of patients with meningococcal disease from younger to older age categories was found, particularly with regard to cases due to meningococci of serogroup B; this shift is explained by the changing distribution of serotypes and subtypes within serogroup B. A polyvalent group B, class 1 outer-membrane-protein vaccine of a stable composition could theoretically have prevented approximately 80% of all group B meningococcal infections in the Netherlands during the past 30 years.
Scholten
R J
RJ
Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam, The Netherlands.
Bijlmer
H A
HA
Poolman
J T
JT
Kuipers
B
B
Caugant
D A
DA
Van Alphen
L
L
Dankert
J
J
Valkenburg
H A
HA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015373:Bacterial Typing Techniques; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000382:microbiology; D009345:Neisseria meningitidis / Q000145:classification*; D009426:Netherlands / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D012703:Serotyping; D013997:Time Factors