Giuseppe
Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extract.]
COMMUNICABLE DISEASE THREATS REPORT
Week 27, 30 June-6 July 2013
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Meningococcal disease - multistate (Europe) - 2013 clusters
Opening date: 28 June 2013 Latest update: 3 July 2013
Epidemiological summary
On 25 June 2013, Germany reported three cases of invasive meningococcal disease (IMD) among men who have sex with men (MSM) caused by N. meningitidis serogroup C. All three isolates were serogroup C, PorAVR1: 5-1; PorA-VR2: 10-8 and FetA: 3-6 and confirmed as ST-11/ET-15. On 26 June, Belgium retrospectively reported a single case of IMD in a MSM diagnosed in March 2013; infection was due to a strain of the same sequence type as the German strain. The patient had reported travel to London in the three weeks prior to onset of illness. On 26 June, France reported three cases of IMD among MSM living in the Paris area. The three isolates were also of the same sequence type as the German and Belgian strains.
Three similar outbreaks have been previously reported among MSM in Canada and the USA. The last one involved 22 cases in New York between 2010 and 2013. All cases were caused by Neisseria meningitidis serogroup C.
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ECDC assessment
The occurrence of clusters of invasive meningococcal disease among MSM in European metropolitan centres caused by a strain that has been associated with a similar outbreak with a high case-fatality rate in New York City indicates an increased risk of IMD among MSM in such settings in Europe. Increased travel and international contact in these settings, including sexual contact with partners from abroad, also in the context of Gay Pride and other festivals, may be factors facilitating the spread of the disease among MSM. Further microbiological studies are needed to provide laboratory evidence of direct or indirect transmission between the European cases, as well as between the European and US cases.
Member States should consider retrospective investigations of cases of serogroup C IMD in young men in order to identify similar cases in the past. Increasing awareness among MSM, through the use of social media and community networks, as well as among healthcare providers is essential for the prevention and early identification of further cases.
More epidemiological studies and better understanding of common risk factors in the European clusters is needed in order to identify groups of MSM at higher risk. Enhanced surveillance over the summer period should be considered at the European level in order to quickly detect possible spread and to coordinate any required response.
Vaccination with conjugate meningococcal vaccine against serogroup C constitutes an effective prevention intervention, and Member States should consider vaccination as a means of outbreak control where clusters in specific target populations are identified.
Actions
ECDC published a rapid risk assessment on 4 July 2013.
The available information has been shared through both EPIS-VPD and EPIS-STI to inform colleagues working with MSM and meningococcal disease and to identify further cases. ECDC will follow-up the genotyping results from France to confirm the link between the cases from the Member States and the New York outbreak.
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COMMUNICABLE DISEASE THREATS REPORT
Week 27, 30 June-6 July 2013
(?)
Meningococcal disease - multistate (Europe) - 2013 clusters
Opening date: 28 June 2013 Latest update: 3 July 2013
Epidemiological summary
On 25 June 2013, Germany reported three cases of invasive meningococcal disease (IMD) among men who have sex with men (MSM) caused by N. meningitidis serogroup C. All three isolates were serogroup C, PorAVR1: 5-1; PorA-VR2: 10-8 and FetA: 3-6 and confirmed as ST-11/ET-15. On 26 June, Belgium retrospectively reported a single case of IMD in a MSM diagnosed in March 2013; infection was due to a strain of the same sequence type as the German strain. The patient had reported travel to London in the three weeks prior to onset of illness. On 26 June, France reported three cases of IMD among MSM living in the Paris area. The three isolates were also of the same sequence type as the German and Belgian strains.
Three similar outbreaks have been previously reported among MSM in Canada and the USA. The last one involved 22 cases in New York between 2010 and 2013. All cases were caused by Neisseria meningitidis serogroup C.
(?)
ECDC assessment
The occurrence of clusters of invasive meningococcal disease among MSM in European metropolitan centres caused by a strain that has been associated with a similar outbreak with a high case-fatality rate in New York City indicates an increased risk of IMD among MSM in such settings in Europe. Increased travel and international contact in these settings, including sexual contact with partners from abroad, also in the context of Gay Pride and other festivals, may be factors facilitating the spread of the disease among MSM. Further microbiological studies are needed to provide laboratory evidence of direct or indirect transmission between the European cases, as well as between the European and US cases.
Member States should consider retrospective investigations of cases of serogroup C IMD in young men in order to identify similar cases in the past. Increasing awareness among MSM, through the use of social media and community networks, as well as among healthcare providers is essential for the prevention and early identification of further cases.
More epidemiological studies and better understanding of common risk factors in the European clusters is needed in order to identify groups of MSM at higher risk. Enhanced surveillance over the summer period should be considered at the European level in order to quickly detect possible spread and to coordinate any required response.
Vaccination with conjugate meningococcal vaccine against serogroup C constitutes an effective prevention intervention, and Member States should consider vaccination as a means of outbreak control where clusters in specific target populations are identified.
Actions
ECDC published a rapid risk assessment on 4 July 2013.
The available information has been shared through both EPIS-VPD and EPIS-STI to inform colleagues working with MSM and meningococcal disease and to identify further cases. ECDC will follow-up the genotyping results from France to confirm the link between the cases from the Member States and the New York outbreak.
(?)
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