The Epidemiology of Meningococcal Disease in New Zealand in 2013

Sunday 16th December 2018


Key findings of meningococcal disease surveillance in 2013

· 68 cases of meningococcal disease were notified. This equates to a notification rate of 1.5 per 100 000 population, the lowest rate of meningococcal disease in New Zealand in more than two decades.

· The number of confirmed cases was 61, giving a confirmation rate of 89.7%. 44 cases were confirmed by the isolation of N. meningitidis and a further 17 by the detection of meningococcal DNA by PCR.

· The strain type was determined for 57 (93.4%) of the 61 confirmed cases. Over 50% of cases were group B strains and 30% were group C strains, with 19.3% due to group B:P1.7-2,4 and 26.3% due to group C:P1.5-1,10-8.


· Counties Manukau District Health Board (DHB) had the highest number of cases (12), followed by Canterbury (8), Waitemata (7) and Southern (7) DHBs. The highest rates of disease were in Counties Manukau (2.3 per 100 000 population, 12 cases) and Southern (2.3 per 100 000 population, 7 cases) DHBs.

· The highest age-specific rates of meningococcal disease continued to occur in children younger than five years: 18.4 per 100 000 population for those aged less than one year and 5.2 per 100 000 population for those aged 1–4 years. As in previous years, a secondary peak in the notification rate was observed for the 15–19 years age group (3.9 per 100 000 population). The 2013 rates of disease for the · Although age-standardised disease rates decreased for all ethnic groups between 2009 and 2013, Māori and Pacific Peoples continued to experience higher rates of disease than the European or Other ethnic group in 2013. The highest rate was in the Pacific Peoples ethnic group (3.1 per 100 000 population, 9 cases), followed by Māori (2.6 per 100 000 population, 23 cases) and European or Other (1.2 per 100 000 population, 34 cases) ethnic groups.

· Hospitalisation status was recorded for all notified cases, and 67 of the 68 cases (98.5%) were hospitalised. For the hospitalised cases, pre-hospital management information was recorded for 65 (97.0%) cases. Of these, 28 cases (43.8%) were seen by a doctor prior to hospital admission and four (6.3%) were given intravenous or intramuscular antibiotics before admission.

· Four fatalities occurred, giving a case-fatality rate of 5.9%. Three of the four fatalities were confirmed cases, one group W135 and one group Y; the other the strain was not identified.

· The antimicrobial susceptibility of 43 viable meningococcal isolates received by ESR from cases of invasive disease in 2013 was tested. All isolates were susceptible to ceftriaxone, rifampicin and ciprofloxacin. More than 30% (14/43) had reduced susceptibility to penicillin, with minimum inhibitory concentrations (MICs) of 0.12–0.5 mg/L.

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Report:

The Epidemiology of Meningococcal Disease in New Zealand in 2013

 

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The Epidemiology of Meningococcal Disease in New Zealand in 2013

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