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Inicio Medicina Clínica (English Edition) The decline of the incidence of meningococcal disease in Barcelona between 1988 ...
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Vol. 151. Issue 10.
Pages 390-396 (November 2018)
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Vol. 151. Issue 10.
Pages 390-396 (November 2018)
Original article
The decline of the incidence of meningococcal disease in Barcelona between 1988 and 2015: The influence of the vaccine against serogroup C
El declive de la incidencia de enfermedad meningocócica en Barcelona entre 1988 y 2015: la influencia de la vacunación frente al serogrupo C
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Sandra Manzanares-Layaa,b,
Corresponding author
, Oleguer Parés-Badella,c, Pilar Gorrindoa, Pere Simóna, Miriam Rosa, Anna de Andrésa, Núria López Segurad, Sonia Brió Sanagustíne, Anna Vilellaf, Carlos Rodrigo Gonzalo de Liriag, Àngels Orcaua,b, Joan A. Caylàa,b
a Servicio de Epidemiología, Agencia de Salud Pública de Barcelona, Barcelona, Spain
b CIBER Epidemiología y Salud Pública (CIBERESP), Spain
c Unidad Docente de Medicina Preventiva y Salud Pública, Hospital del Mar, UPF-ASPB, Barcelona, Spain
d Servicio de Pediatría, Hospital del Mar, Barcelona, Spain
e Unidad de Cuidados Intensivos Pediátricos, Hospital de Sant Pau, Barcelona, Spain
f Servicio de Medicina Preventiva, Hospital Clínico Universitario de Barcelona, Barcelona, Spain
g Servicio de Pediatría, Hospital Universitario Vall d’Hebrón, Barcelona, Spain
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Tables (2)
Table 1. Incidence rate per 100,000 inhabitants in residents of Barcelona and ratio of meningococcal disease rates during the periods 1997–2000 and 2001–2007 according to N. meningitidis serogroup and age groups.
Table 2. Incidence rate per 100,000 inhabitants in residents of Barcelona and ratio of meningococcal disease rates during the periods 1997–2000 and 2001–2015 according to N. meningitidis serogroup and age groups.
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Abstract
Introduction and objective

The purpose of this study was to describe the evolution of meningococcal disease (MD) in the city of Barcelona between 1988 and 2015 and to assess the impact of the vaccine against serogroup C.

Materials and methodology

The evolution of MD and by serogroup was analyzed using the information included in the mandatory notification diseases registry. Incidences of all serogroups between the periods of before and after the implementation of the serogroup C vaccine in 2000 were compared. Vaccination coverage among cases, serogroup among vaccinated cases and mortality and case fatality rates were analyzed.

Results

MD has evolved from an incidence rate in children aged under 1 of 63.09 cases per 100,000 in 1997–2000 to 15.44 per 100,000 in 2001–2015. All MD serogroups incidences decreased after the implementation of the vaccine, especially for serogroup C among children aged between 1 and 4. Since 2000 vaccine coverage in MD cases by this serogroup was 7.6% while in those affected by serogroup B it was 35.0% (p<0.01). Among those vaccinated, 66.4% of cases were serogroup B and 5.2% were C (p<0.01). Mortality and case fatality rates were 7.7% and 0.19/100,000 respectively, without significant changes in time regarding case fatality.

Conclusions

Incidence caused by serogroups B and C has decreased after the systematic vaccination against serogroup C. Vaccination against serogroup B could further reduce the impact of this lethal disease which has not decreased during this period.

Keywords:
Meningitis meningococcal
Vaccination
Incidence
Mortality
Disease notification
Resumen
Introducción y objetivo

El objetivo es conocer la evolución de la enfermedad meningocócica en la ciudad de Barcelona entre 1988 y 2015 y evaluar el impacto de la vacuna contra el serogrupo C.

Materiales y métodos

Se analizó la evolución de casos de enfermedad meningocócica y por serogrupo a partir del registro de enfermedades de declaración obligatoria. Se comparó la incidencia de todos los serogrupos antes y después de la introducción de la vacunación contra el serogrupo C en el año 2000. Se analizó la cobertura vacunal entre los casos, el serogrupo entre casos vacunados y la tasa de mortalidad y letalidad.

Resultados

La enfermedad meningocócica ha pasado de una incidencia en menores de un año de 63,09 casos por 100.000 en 1997-2000 a 15,44 en 2001-2015. Todos los serogrupos han disminuido su incidencia tras la implementación vacunal, especialmente en niños de uno a 4 años para el C. A partir del 2000 la cobertura vacunal en los casos por este serogrupo era del 7,6% y en los afectos por el B era del 35,0% (p<0,01). De los vacunados, el 66,4% de los casos fue serogrupo B y un 5,2% fue C (p<0,01). La tasa global de letalidad y de mortalidad fue del 7,7% y del 0,19/100.000 respectivamente, sin cambios significativos en el tiempo en cuanto a la letalidad.

Conclusiones

La incidencia por serogrupo C y también por B ha disminuido tras la vacunación sistemática contra el serogrupo C. La vacunación contra el serogrupo B podría reducir aún más esta grave enfermedad con una letalidad importante que no ha disminuido en todo el periodo.

Palabras clave:
Meningitis meningocócica
Vacunación
Incidencia
Mortalidad
Notificación de enfermedad

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