BackgroundThe total incidence of invasive meningococcal disease (IMD) in Europe has been declining in recent years; however, a rising incidence due to serogroup W (MenW), predominantly sequence type 11 (ST-11), clonal complex 11 (cc11), was reported in some European countries.AimThe aim of this study was to compile the most recent laboratory surveillance data on MenW IMD from several European countries to assess recent trends in Europe.MethodsIn this observational, retrospective study, IMD surveillance data collected from 2013-17 by national reference laboratories and surveillance units from 13 European countries were analysed using descriptive statistics.ResultsThe overall incidence of IMD has been stable during the study period. Incidence of MenW IMD per 100,000 population (2013: 0.03; 2014: 0.05; 2015: 0.08; 2016: 0.11; 2017: 0.11) and the proportion of this serogroup among all invasive cases (2013: 5% (116/2,216); 2014: 9% (161/1,761); 2015: 13% (271/2,074); 2016: 17% (388/2,222); 2017: 19% (393/2,112)) continuously increased. The most affected countries were England, the Netherlands, Switzerland and Sweden. MenW was more frequent in older age groups (≥ 45 years), while the proportion in children (< 15 years) was lower than in other age groups. Of the culture-confirmed MenW IMD cases, 80% (615/767) were caused by hypervirulent cc11.ConclusionDuring the years 2013-17, an increase in MenW IMD, mainly caused by MenW cc11, was observed in the majority of European countries. Given the unpredictable nature of meningococcal spread and the epidemiological potential of cc11, European countries may consider preventive strategies adapted to their contexts.

Department of Epidemiology and Surveillance National Institute for Public Health and the Environment Bilthoven the Netherlands

Department of Health Security National Institute for Health and Welfare Helsinki Finland

Department of Infectious Diseases National Institute of Health Dr Ricardo Jorge Lisboa Portugal

Dept of Infectious Diseases Istituto Superiore di Sanità Rome Italy

Division for Infection Control and Environmental Health Norwegian Institute of Public Health Oslo Norway

Division of Communicable Diseases Federal Office of Public Health Bern Switzerland

Division of Infectious Diseases Geneva University Hospitals Geneva Switzerland

Institute for Hygiene and Microbiology University of Würzburg Würzburg Germany

Meningococcal Reference Unit Public Health England Manchester United Kingdom

National Meningitis Reference Laboratory National School of Public Health Athens Greece

National Reference Centre for Bacterial Meningitis National Medicines Institute Warsaw Poland

National Reference Laboratory for Meningococcal Infections National Institute of Public Health Prague Czech Republic

National Reference Laboratory for Neisseria meningitidis Department of Laboratory Medicine Faculty of Medicine and Health Örebro University Örebro Sweden

Spanish Reference Laboratory for Meningococci National Centre for Microbiology Instituto de Salud Carlos 3 Madrid Spain

The Netherlands Reference Laboratory for Bacterial Meningitis Department of Medical Microbiology Academic Medical Center Amsterdam Netherlands

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Invasive meningococcal disease in South-Eastern European countries: Do we need to revise vaccination strategies?

Real-world impact and effectiveness of MenACWY-TT