J Med Microbiol Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gray, S. J.
Right arrow Articles by Kaczmarski, E. B.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gray, S. J.
Right arrow Articles by Kaczmarski, E. B.
Agricola
Right arrow Articles by Gray, S. J.
Right arrow Articles by Kaczmarski, E. B.
J Med Microbiol 55 (2006), 887-896; DOI: 10.1099/jmm.0.46288-0
© 2006 Society for General Microbiology
ISSN 1473-5644

Epidemiology of meningococcal disease in England and Wales 1993/94 to 2003/04: contribution and experiences of the Meningococcal Reference Unit

Stephen J. Gray1, Caroline L. Trotter2, Mary E. Ramsay2, Malcolm Guiver1, Andrew J. Fox1, Raymond Borrow1, Richard H. Mallard1 and Edward B. Kaczmarski1

1 Meningococcal Reference Unit, Health Protection Agency, Manchester Medical Microbiology Partnership, Manchester Royal Infirmary, Manchester M13 9WZ, UK

2 Immunisation Department, Health Protection Agency Centre for Infections, Colindale, London, UK

Correspondence
Stephen J. Gray
steve.gray{at}hpa.org.uk

Received 10 August 2005
Accepted 20 February 2006

The laboratory confirmation of meningococcal disease and characterization of Neisseria meningitidis isolates was improved considerably in England and Wales by the Meningococcal Reference Unit between epidemiological years 1993/94 and 2003/04 to meet the challenge of increasing numbers of cases of clinical disease and the requirement for enhanced surveillance. Improved case ascertainment was made possible by the rapid introduction of an innovative centralized reference service for non-culture PCR-based DNA detection of meningococci utilizing the ctrA and siaD PCR assays, complemented by consistent phenotypic characterization of submitted isolates from culture-proven cases. This allowed the increased prevalence of serogroup C disease in specific age groups and the apparent associated increase in mortality from 1995/96 to 1999/00 to be defined, thereby prompting accelerated intervention with the newly licensed meningococcal serogroup C conjugate (MCC) vaccines into the under-25-year UK population (in November 1999). The continued increase in and predominance of serogroup B cases (1993/94 to 2000/01) were observed in conjunction with their diverse and changing phenotypic characteristics. Trends observed to be associated with the predominant phenotypic combinations of serogroup, serotype and sero-subtype were: a decline of both C : 2b and B : 2b meningococci, and a decline of B : 15 : P1.7,16 with a concomitant increase of B : 4 : P1.4 over the 11-year period. Detailed routine surveillance rapidly confirmed the introduction of W135 : 2a : P1.5,2 meningococci into the UK during 2000 and 2001. The importance of continued detailed surveillance of this important pathogen cannot be overestimated, both to monitor the effectiveness of the MCC vaccine and to identify changes within the meningococcal population that can inform the design of anti-serogroup B vaccines.

Abbreviations: CFR, case fatality ratio; CSF, cerebrospinal fluid; HPA, Health Protection Agency; MCC, meningococcal serogroup C conjugate; MRU, Meningococcal Reference Unit; NT, non-typeable; OMP, outer-membrane protein.




This article has been cited by other articles:


Home page
 BMJHome page
D. Isaacs
Commentary: Controversies in SIGN guidance on management of invasive meningococcal disease in children and young people
BMJ, June 14, 2008; 336(7657): 1370 - 1371.
[Full Text] [PDF]

Home page
 Infect. Immun.Home page
P. T. Beernink and D. M. Granoff
Bactericidal Antibody Responses Induced by Meningococcal Recombinant Chimeric Factor H-Binding Protein Vaccines
Infect. Immun., June 1, 2008; 76(6): 2568 - 2575.
[Abstract] [Full Text] [PDF]

Home page
 MicrobiologyHome page
J. S. Bennett, M. J. Callaghan, J. P. Derrick, and M. C. J. Maiden
Variation in the Neisseria lactamica porin, and its relationship to meningococcal PorB
Microbiology, May 1, 2008; 154(5): 1525 - 1534.
[Abstract] [Full Text] [PDF]

Home page
 J. Mol. Diagn.Home page
C. E. Corless, E. Kaczmarski, R. Borrow, and M. Guiver
Molecular Characterization of Neisseria meningitidis Isolates Using a Resequencing DNA Microarray
J. Mol. Diagn., May 1, 2008; 10(3): 265 - 271.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
L. H. Harrison
A Multivalent Conjugate Vaccine for Prevention of Meningococcal Disease in Infants
JAMA, January 9, 2008; 299(2): 217 - 219.
[Full Text] [PDF]

Home page
 CVIHome page
J. Findlow, A. Holland, N. Andrews, V. Weynants, F. Sotolongo, P. Balmer, J. Poolman, and R. Borrow
Comparison of Phenotypically Indistinguishable but Geographically Distinct Neisseria meningitidis Group B Isolates in a Serum Bactericidal Antibody Assay
Clin. Vaccine Immunol., November 1, 2007; 14(11): 1451 - 1457.
[Abstract] [Full Text] [PDF]

Home page
 CVIHome page
C. Trotter, J. Findlow, P. Balmer, A. Holland, R. Barchha, N. Hamer, N. Andrews, E. Miller, and R. Borrow
Seroprevalence of Bactericidal and Anti-Outer Membrane Vesicle Antibodies to Neisseria meningitidis Group B in England
Clin. Vaccine Immunol., July 1, 2007; 14(7): 863 - 868.
[Abstract] [Full Text] [PDF]

Home page
 BMJHome page
C A. Hart and A. P J Thomson
Meningococcal disease and its management in children.
BMJ, September 30, 2006; 333(7570): 685 - 690.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
INT J SYST EVOL MICROBIOL J MED MICROBIOL MICROBIOLOGY J GEN VIROL ALL SGM JOURNALS
Copyright © 2006 Society for General Microbiology.