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Publication
Epidemiology of invasive meningococcal disease in Portugal from 2012 to 2022
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Advisor(s)
Abstract(s)
Backroud and aim: Surveillance of invasive meningococcal disease (IMD) is essential to monitor changes in the epidemiology of the disease and for
more effective infection control.
In Portugal, a surveillance system based on mandatory clinical and laboratory notifications was implemented in late 2002, with
the laboratory component under the responsibility of the National Reference Laboratory (NRL) for Neisseria meningitidis. In
addition, since 2017, whole genome sequencing (WGS) has been routinely implemented at the NRL as a reference typing method
for IMD surveillance. This work aims to analyze both the epidemiology of IMD and the genetic diversity of Neisseria meningitidis strains during the
last 11 years (2012-2022) in Portugal. Conclusion: Although the incidence of meningococcal disease has decreased over the past 11 years in Portugal, MenB meningococci are still an important cause of meningitis and septicaemia. While serogroup C IMD was rare and restricted to adults, serogroup Y IMD affected all age groups. On the other hand, serogroup W IMD has been increasing since 2017, initially in adults and later (2019) in children under 4 years of age.
WGS analysis revealed a high genetic diversity among N. meningitidis isolates, especially in the population of MenB isolates. The increased
circulation of MenB cc213 strains observed over these nine years is particularly important and deserves close monitoring, given the predicted
low coverage of this strain by the 4CMenB vaccine [6]. In addition, the slight increase in IMD cases due to the MenW cc11 strains, previously
identified as clustered into two sublineages the “Original UK” and “UK 2013” strains [7], should also be monitored, as these strains are
associated with an unusual clinical presentation and a higher lethality rate compared to other IMD serogroups [8, 9].
Our results underline the need for continuous surveillance of N. meningitidis infections susceptible to changes in their pattern, in order to
promptly adapt IMD control strategies in Portugal.
Description
Keywords
Invasive Meningococcal Disease Epidemiology Surveillance Whole Genome Sequencing Portugal