title: Reduction in Neisseria meningitidis infection in Italy after Meningococcal C conjugate vaccine introduction: A time trend analysis of 1994-2012 series.
abstract: The incidence of invasive meningococcal disease (IMD) in Italy is among the lowest in Europe. Meningococcal C conjugate vaccine (MCC) was introduced in 2005 for 12 months old infants. The aim of this study was to describe the epidemiology of IMD in Italy from 1994 to 2012 and to evaluate the impact of MCC introduction. Data about Neisseria meningitidis (N. meningitidis) cases were drawn from the National Surveillance of Invasive Bacterial Diseases. The average incidence of IMD during 1994-2012 in Italy was 0.36 per 100,000 (95%CI 0.30; 0.40). N. meningitidis B was the most frequent serogroup and infants less than 12 months old were the most affected. Joinpoint analysis showed a statistically significant reduction in the incidence of N. meningitidis C related IMD after MCC introduction: the Annual Percentage Change declined from 21.8 (95%CI 15.1; 28.9) in 1994-2005 to -19.9 (95%CI -28.2; -10.7) afterwards. No changes were observed with respect to N. meningitidis B related IMD. Poisson regression showed a statistically significant reduction in the incidence of IMD both associated to N. meningitidis C (Incidence Rate Ratio 0.33; 95%CI 0.29; 0.37) and due to all serogroups (Incidence Rate Ratio 0.70; 95%CI 0.65; 0.75) in the post-vaccination period compared to the pre-vaccination one. On the other hand, the incidence of N. meningitidis B related IMD did not decrease. Our results suggest that MCC had an impact in decreasing the incidence of N. meningitidis C related IMD. However, data on typing are incomplete and efforts are needed to make them available for studying the need and the impact of other meningococcal vaccines.
authors: a Catholic University of the Sacred Heart ; Department of Public Health ; Rome , Italy.
authors: Chiara
authors: C
authors: de Waure
authors: b Florence Local Health Authority; Preventive Health Care Unit ; Florence , Italy.
authors: Alessandro
authors: A
authors: Miglietta
authors: c University of Nis; Center for Biomedical Research ; Nis , Serbia.
authors: Darko
authors: D
authors: Nedovic
authors: b Florence Local Health Authority; Preventive Health Care Unit ; Florence , Italy.
authors: Giovanna
authors: G
authors: Mereu
authors: a Catholic University of the Sacred Heart ; Department of Public Health ; Rome , Italy.
authors: Walter
authors: W
authors: Ricciardi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D022401:Meningococcal Vaccines / Q000276:immunology*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000276:immunology*; D065288:Serogroup; D014611:Vaccination; D018074:Vaccines, Conjugate / Q000276:immunology*; D055815:Young Adult
chemical_list: D022401:Meningococcal Vaccines; D018074:Vaccines, Conjugate; C410218:serogroup C meningococcal conjugate vaccine
keywords: Neisseria meningitidis; epidemiology; meningococcal C conjugate Vaccine; surveillance; time analysis