title: Invasive meningococcal capsular group Y disease, England and Wales, 2007-2009.
abstract: Enhanced national surveillance for invasive meningococcal disease in England and Wales identified an increase in laboratory-confirmed capsular group Y (MenY) disease from 34 cases in 2007 to 44 in 2008 and 65 in 2009. For cases diagnosed in 2009, patient median age at disease onset was 60 years; 39% of patients had underlying medical conditions, and 19% died. MenY isolates causing invasive disease during 2007-2009 belonged mainly to 1 of 4 clonal complexes (cc), cc23 (56% of isolates), cc174 (21%), cc167 (11%), and cc22 (8%). The 2009 increase resulted primarily from sequence type 1655 (cc23) (22 cases in 2009, compared with 4 cases each in 2007 and 2008). cc23 was associated with lpxL1 mutations and meningitis in younger age groups (<25 years); cc174 was associated with nonmeningitis, particularly pneumonia, in older age groups (>65 years). The increase in MenY disease requires careful epidemiologic and molecular monitoring.
authors.affiliation: Department, Health Protection Agency Colindale, 61 Colindale Ave, London NW9 5EQ, UK. shamez.ladhani@hpa.org.uk
authors.forename: Shamez N
authors.initials: SN
authors.lastname: Ladhani
authors.forename: Jay
authors.initials: J
authors.lastname: Lucidarme
authors.forename: Lynne S
authors.initials: LS
authors.lastname: Newbold
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gray
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Carr
authors.forename: Jamie
authors.initials: J
authors.lastname: Findlow
authors.forename: Mary E
authors.initials: ME
authors.lastname: Ramsay
authors.forename: Edward B
authors.initials: EB
authors.lastname: Kaczmarski
authors.forename: Raymond
authors.initials: R
authors.lastname: Borrow
mesh_terms: D000217:Acyltransferases / Q000235:genetics / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D015964:Gene Expression Regulation, Bacterial; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D008875:Middle Aged; D009154:Mutation; D038581:Neisseria meningitidis, Serogroup Y / Q000145:classification / Q000302:isolation & purification*; D011159:Population Surveillance; D013997:Time Factors; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001426:Bacterial Proteins; D000217:Acyltransferases; C118473:LpxL protein, bacteria