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The Disease Burden of Invasive Meningococcal Serogroup B Disease in Canada

Bettinger, Julie A. PhD*; Scheifele, David W. MD*; Le Saux, Nicole MD; Halperin, Scott A. MD; Vaudry, Wendy MD§; Tsang, Raymond PhD; for the Members of the Canadian Immunization Monitoring Program, Active (IMPACT)

Pediatric Infectious Disease Journal: January 2013 - Volume 32 - Issue 1 - p e20–e25
doi: 10.1097/INF.0b013e3182706b89
Original Studies

Background: Invasive meningococcal disease remains a rare but deadly infection in Canada. New serogroup B vaccines may offer the potential for prevention and control. This report examines the disease burden caused by serogroup B invasive meningococcal infections.

Methods: From 2002 to 2011, active, population-based metropolitan area surveillance for adult and pediatric hospital admissions for adult and pediatric hospital admissions for laboratory-confirmed infection with Neisseria meningitidis, was conducted by the 12 centers of the Canadian Immunization Monitoring Program, Active.

Results: A total of 769 invasive meningococcal cases occurred from 2002 to 2011; 54% (n = 413) in children with a peak incidence of 6.16 (95% confidence interval: 3.18–10.76) per 100,000 in children aged <1 year in 2009. Serogroup B accounted for the largest proportion of cases and had the highest incidence of all serogroups across all ages, with a peak incidence of 0.31 (0.23–0.40) per 100,000 in 2007. Serogroup B case fatality rate was 4.3% in children, and 21% of pediatric survivors had sequelae. B:17:P1.19 ST-269 was the most frequently detected antigenic type.

Conclusions: Serogroup B invasive meningococcal infections caused substantial morbidity and mortality and are the leading cause of invasive meningococcal disease in Canada. The proportion of cases potentially preventable with the new serogroup B vaccines should be evaluated to determine whether universal immunization programs are warranted.

From the *Vaccine Evaluation Center, BC Children’s Hospital and the University of British Columbia, Vancouver, British Columbia; Children’s Hospital of Eastern Ontario and the University of Ottawa, Ottawa, Ontario; Canadian Center for Vaccinology, IWK Health Centre and Dalhousie University, Halifax, Nova Scotia; §Stollery Children’s Hospital and University of Alberta, Edmonton, Alberta; National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.

Accepted for publication August 22, 2012.

JAB was on an ad-hoc Advisory Board for Novartis Vaccines, Dorval, Quebec, Canada and has received speaker honoraria from Novartis Vaccines, Dorval, Quebec, Canada; Pfizer Vaccines, New York, New York, USA; and Baxter AG, Vienna, Austria. SAH was on ad-hoc Advisory Board for Novartis Vaccines and received speaker honoraria in the past year from Novartis Vaccines. DWS was on an ad-hoc Advisory Board for Novartis Vaccines. The authors have no other funding or conflicts of interest to disclose.

This study was supported by a grant from Sanofi-Pasteur to the Canadian Pediatric Society. The funders had no role in study design, data collection and analysis, decision to publish, preparation or approval of the manuscript. The Canadian Immunization Monitoring Program, Active (IMPACT) is a national surveillance initiative managed by the Canadian Paediatric Society and conducted by the IMPACT network of pediatric investigators

Address for correspondence: Julie A. Bettinger, PhD, Vaccine Evaluation Center, BC Children’s Hospital, A5-950 West 28th Street, Vancouver, British Columbia, V5Z 4H4, Canada. E-mail: jbettinger@cfri.ca.

© 2013 Lippincott Williams & Wilkins, Inc.