title: Climate, demographic factors and geographical variations in the incidence of invasive meningococcal disease in Italy.
abstract: We investigated the effect of climatic, demographic factors and intra-country geographical variations on the incidence of invasive meningococcal disease (IMD) in Italy. For this purpose, incidence rates of IMD cases reported in Italy between 1994 and 2012 were calculated, and a cluster analysis was performed. A geographical gradient was determined, with lower incidence rates in central and southern Italy, compared to the northern parts, where most clusters were observed. IMD rates were higher in medium-sized towns than in villages. Adults were at lower risk of IMD than children aged ⩽4 years. IMD incidence tended to decrease with increasing monthly mean temperatures (incidence rate ratio 0·94, 95% confidence interval 0·90-0·99). In conclusion, geographical variations in IMD incidence were found, where age and temperature were associated with disease occurrence. Whether geographical variations should be considered in national intervention plans is still a matter for discussion.
authors.affiliation: Department of Infectious,Parasitic & Immuno-mediated Diseases,Istituto Superiore di Sanità,Rome,Italy.
authors.forename: F
authors.initials: F
authors.lastname: Vescio
authors.affiliation: Department of Veterinary Public Health and Food Safety,Istituto Superiore di Sanità,Rome,Italy.
authors.forename: L
authors.initials: L
authors.lastname: Busani
authors.affiliation: National Institute for Public Health and the Environment (RIVM),Centre for Infectious Disease Control (CIb),Bilthoven,The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Mughini Gras
authors.affiliation: Department of Infectious,Parasitic & Immuno-mediated Diseases,Istituto Superiore di Sanità,Rome,Italy.
authors.forename: C
authors.initials: C
authors.lastname: Fazio
authors.affiliation: Department of Infectious,Parasitic & Immuno-mediated Diseases,Istituto Superiore di Sanità,Rome,Italy.
authors.forename: A
authors.initials: A
authors.lastname: Neri
authors.affiliation: Department of Infectious,Parasitic & Immuno-mediated Diseases,Istituto Superiore di Sanità,Rome,Italy.
authors.forename: L
authors.initials: L
authors.lastname: Avellis
authors.affiliation: Department of Infectious,Parasitic & Immuno-mediated Diseases,Istituto Superiore di Sanità,Rome,Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rezza
authors.affiliation: Department of Infectious,Parasitic & Immuno-mediated Diseases,Istituto Superiore di Sanità,Rome,Italy.
authors.forename: P
authors.initials: P
authors.lastname: Stefanelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000531:Altitude; D002648:Child; D002675:Child, Preschool; D002980:Climate; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology*; D008589:Meningococcal Infections / Q000453:epidemiology; D008875:Middle Aged; D062211:Spatio-Temporal Analysis; D014507:Urbanization; D055815:Young Adult
keywords: IMD incidence