Interconnected clusters of invasive meningococcal disease due to Neisseria meningitidis serogroup C ST-11 (cc11), involving bisexuals and men who have sex with men, with discos and gay-venues hotspots of transmission, Tuscany, Italy, 2015 to 2016.
Interconnected clusters of invasive meningococcal disease due to Neisseria meningitidis serogroup C ST-11 (cc11), involving bisexuals and men who have sex with men, with discos and gay-venues hotspots of transmission, Tuscany, Italy, 2015 to 2016.
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DOI：
10.2807/1560-7917.es.2018.23.34.1700636
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发表时间：
2018-08
期刊：
影响因子：
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通讯作者：
Stefanelli P
中科院分区：
文献类型：
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作者：
Miglietta A;Fazio C;Neri A;Pezzotti P;Innocenti F;Azzari C;Rossolini GM;Moriondo M;Nieddu F;Iannazzo S;D'Ancona F;Maraglino FP;Guerra R;Rezza G;Voller F;Stefanelli P
2015 年，意大利托斯卡纳地区 C 群 (MenC) 引起的侵袭性脑膜炎球菌病发病率有所增加。这促使托斯卡纳地区卫生局实施了反应性免疫运动，并启动了流行病学现场调查，旨在解决有针对性的免疫干预措施。 2011-14 年，报告了 10 例 MenC 病例，而 2015-16 年报告了 62 例。病死率为21%（n = 13），其中51例（82.3%）被确诊为C:P1.5–1,10–8:F3–6:ST-11(cc11)。总体而言，共识别出 17 个集群。 6 个迪斯科舞厅和 4 个同性恋场所被发现是传播热点，在症状出现前 10 天内分别有 20 例和 14 例病例去过该场所。男男性行为者（MSM）和双性恋者分别发生了 10 起和 3 起案件，涉及 11 个聚集性感染群。此外，还发现了前往同性恋场所的异性恋病例（n = 5）。未发现继发病例。分子分型表明与最近在欧洲和美国的同性恋、双性恋和其他 MSM 中描述的 MenC 簇有密切关系，表明血清群 C 变体 P1.5–1,10–8:F3–6:ST-11(cc11) 可能在该人群中进行国际传播；然而，尚未确定流行病学联系。 2016 年 12 月，实施了一项涉及迪斯科舞厅和女同性恋、男同性恋、双性恋和跨性别者 (LGBT) 协会的有针对性的疫苗接种运动。 2017 年，发生了 10 例 MenC 病例，而 2015 年和 2016 年分别报告了 32 例和 30 例，这表明反应性和针对性免疫规划的有效性。
In 2015 an increased incidence of invasive meningococcal disease due to serogroup-C (MenC) occurred in Tuscany, Italy. This led the Regional Health Authority of Tuscany to implement a reactive immunisation campaign and to launch an epidemiological field investigation aiming to address targeted immunisation interventions. In 2011–14, 10 MenC cases had been reported compared with 62 cases in 2015–16. The case fatality rate was 21% (n = 13) and 51 cases (82.3%) were confirmed as C:P1.5–1,10–8:F3–6:ST-11(cc11). Overall, 17 clusters were recognised. Six discos and four gay-venues were found to have a role as transmission-hotspots, having been attended by 20 and 14 cases in the 10 days before symptoms onset. Ten and three cases occurred, respectively, among men who have sex with men (MSM) and bisexual individuals, who were involved in 11 clusters. In addition, heterosexual cases (n = 5) attending gay-venues were also found. Secondary cases were not identified. Molecular typing indicated close relationship with MenC clusters recently described among gay, bisexual and other MSM in Europe and the United States, suggesting a possible international spread of the serogroup-C-variant P1.5–1,10–8:F3–6:ST-11(cc11) in this population-group; however, epidemiological links were not identified. In December 2016, a targeted vaccination campaign involving discos and lesbian, gay, bisexual, and transgender (LGBT) associations was implemented. During 2017, 10 cases of MenC occurred, compared with 32 and 30 cases reported in 2015 and 2016 respectively, suggesting the effectiveness of the reactive and targeted immunisation programmes.