title: Clinical characteristics and public health management of invasive meningococcal group W disease in the East Midlands region of England, United Kingdom, 2011 to 2013.
abstract: In England and Wales, meningococcal disease caused by group W has historically been associated with outbreaks of disease among travellers to high-risk countries. Following a large outbreak associated with travel to the Hajj in 2000, the number of cases declined and, in 2008, only 19 laboratory-confirmed cases were identified nationally. In 2013, in the East Midlands region of England, eight cases of meningococcal disease caused by this serogroup were recorded, compared with six from 2011 to 2012. To explore this further, data for all cases with a date of onset between 1 January 2011 and 31 December 2013 were collected. Data collected included geographical location, clinical presentation and outcome. Fourteen cases were identified; two died as a result of their illness and two developed long-term health problems. No commonality in terms of geographical location, shared space or activities was identified, suggesting that group W is circulating endemically with local transmission. Clinical presentation was variable. Half presented with symptoms not typical of a classical meningococcal disease, including two cases of cellulitis, which may have implications for clinicians, in terms of timely identification and treatment, and public health specialists, for offering timely antibiotic chemoprophylaxis to close contacts.
authors.affiliation: Centre for Medicine, Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, The University of Leicester, Leicester, United Kingdom.
authors.forename: Jane
authors.initials: J
authors.lastname: Bethea
authors.forename: Sophia
authors.initials: S
authors.lastname: Makki
authors.forename: Steve
authors.initials: S
authors.lastname: Gray
authors.forename: Vanessa
authors.initials: V
authors.lastname: MacGregor
authors.forename: Shamez
authors.initials: S
authors.lastname: Ladhani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control*; D022401:Meningococcal Vaccines / Q000627:therapeutic use*; D008875:Middle Aged; D015995:Prevalence; D011635:Public Health Administration / Q000379:methods*; D012068:Religion and Medicine; D012307:Risk Factors; D014195:Travel; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D022401:Meningococcal Vaccines
keywords: Public Health Policy; W135,Clinical presentation, Notification; meningococcal disease