Meningococcal Disease in the Netherlands, 1958–1990: A Steady Increase in the Incidence Since 1982 Partially Caused by New Serotypes and Subtypes of Neisseria meningitidis

In order to explain a threefold increase in the incidence of meningococcal disease in the Netherlands during the 1980s, we serotyped and subtyped Neisseria meningitidis isolates recovered between 1958 and 1990 from >3,000 patients with systemic disease. No single strain could be held responsible...

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Bibliographic Details
Published in:Clinical infectious diseases 1993-02, Vol.16 (2), p.237-246
Main Authors: Scholten, Rob J. P. M., Bijlmer, Henk A., Poolman, Jan T., Kuipers, Betsy, Caugant, Dominique A., Van Alphen, Loek, Dankert, Jacob, Valkenburg, Hans A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age distribution
Age Factors
Bacterial meningitis
Bacterial Typing Techniques
Blood
Child
Child, Preschool
Clinical Infectious Disease Articles
Epidemics
Epidemiology
Humans
Infant
Infant, Newborn
Infections
Meningitis, Meningococcal - epidemiology
Meningitis, Meningococcal - microbiology
Monoclonal antibodies
Neisseria meningitidis
Neisseria meningitidis - classification
Netherlands - epidemiology
Phenotypes
Seroepidemiologic Studies
Serotyping
Time Factors
Vaccination
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Summary:In order to explain a threefold increase in the incidence of meningococcal disease in the Netherlands during the 1980s, we serotyped and subtyped Neisseria meningitidis isolates recovered between 1958 and 1990 from >3,000 patients with systemic disease. No single strain could be held responsible for the increase. Apart from the newly introduced strain B:4:P1.4, which became the most prevalent phenotype in 1990 (21% of all isolates), the majority of the cases in 1990 were caused by many different strains that were already present in the Netherlands before 1980. For the period 1980–1990, a shift in the age distribution of patients with meningococcal disease from younger to older age categories was found, particularly with regard to cases due to meningococci of serogroup B; this shift is explained by the changing distribution of serotypes and subtypes within serogroup B. A polyvalent group B, class 1 outer-membrane-protein vaccine of a stable composition could theoretically have prevented ∼80% of all group B meningococcal infections in the Netherlands during the past 30 years.
ISSN:1058-4838
1537-6591
DOI:10.1093/clind/16.2.237