title: Characteristics and changes in invasive meningococcal disease epidemiology in France, 2006-2015.
abstract: This work aimed to describe the epidemiology of invasive meningococcal disease (IMD) in France, 2006-2015, including group- and genotype-specific disease burden, incidence trends before and after introduction of meningococcal C conjugate vaccines (MCCV) in 2010, and factors influencing the case fatality rate.
  
  
  
  Mandatory notification data on incidence and IMD case characteristics were used. Genotyping of invasive strains and whole genome sequencing were performed by the French National Reference Center. Vaccination coverage was estimated from the National Health Insurance Information System's reimbursement data.
  
  
  
  The decrease in annual IMD incidence rates (per 100,000 inhabitants) from 1.23 in 2006 to 0.78 in 2016 was mainly related to the decrease in group B IMD. Group C incidence decreased from 0.29 in 2006 to 0.13 in 2010 but increased thereafter in age groups not targeted by MCCV. From 2010 onwards, MCCV coverage gradually increased but remained below 25% in 15-19 year-olds in 2015. Age, clinical presentation and, to a lesser extent, clonal complex 11 were the most significant factors determining mortality.
  
  
  
  The limited impact of vaccination on group C IMD incidence may be explained by the emergence of a new epidemic cycle in 2011 and the low vaccination coverage rates among adolescents and young adults.
authors.affiliation: Santé publique France, French National Public Health Agency, F-94415, Saint-Maurice, France.
authors.forename: I
authors.initials: I
authors.lastname: Parent du Chatelet
authors.affiliation: National Reference Center for Meningococci, Institut Pasteur, F-75015, Paris, France.
authors.forename: A E
authors.initials: AE
authors.lastname: Deghmane
authors.affiliation: Santé publique France, French National Public Health Agency, F-94415, Saint-Maurice, France.
authors.forename: D
authors.initials: D
authors.lastname: Antona
authors.affiliation: National Reference Center for Meningococci, Institut Pasteur, F-75015, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Hong
authors.affiliation: Santé publique France, French National Public Health Agency, F-94415, Saint-Maurice, France.
authors.forename: L
authors.initials: L
authors.lastname: Fonteneau
authors.affiliation: National Reference Center for Meningococci, Institut Pasteur, F-75015, Paris, France.
authors.forename: M K
authors.initials: MK
authors.lastname: Taha
authors.affiliation: Santé publique France, French National Public Health Agency, F-94415, Saint-Maurice, France. Electronic address: daniel.levy-bruhl@santepubliquefrance.fr.
authors.forename: D
authors.initials: D
authors.lastname: Lévy-Bruhl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D058872:Epidemics / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D022401:Meningococcal Vaccines / Q000008:administration & dosage; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D038541:Neisseria meningitidis, Serogroup B / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity; D014611:Vaccination / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D022401:Meningococcal Vaccines; C410218:serogroup C meningococcal conjugate vaccine
keywords: Epidemiology; France; Invasive meningococcal disease; Meningococcal C conjugate vaccination; Neisseria meningitidis