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      Necrotising fasciitis as atypical presentation of infection with emerging Neisseria meningitidis serogroup W (MenW) clonal complex 11, the Netherlands, March 2017

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          Abstract

          In March 2017, a patient with necrotising fasciitis caused by Neisseria meningitidis serogroup W (MenW) clonal complex 11 was diagnosed in the Netherlands. Unusual and severe presentations of MenW infections are common in the current European epidemic. In the Netherlands, the incidence of MenW infections increased 10-fold, from an average of 0.03 per 100,000 population in 2002–2014 to 0.29 in 2016. Awareness of atypical presentations enables timely adequate treatment and public health action.

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          Increase in endemic Neisseria meningitidis capsular group W sequence type 11 complex associated with severe invasive disease in England and Wales.

          Shamez Ladhani, Kazim Beebeejaun, Jay Lucidarme … (2015)
          In England and Wales, the incidence of invasive meningococcal disease has been declining for more than a decade, but meningococcal group W (MenW) cases have been increasing since 2009.
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            Emergency Meningococcal ACWY Vaccination Program for Teenagers to Control Group W Meningococcal Disease, England, 2015–2016

            Helen E. Campbell, Michael Edelstein, Nick Andrews … (2017)
            During the first 12 months of an emergency meningococcal ACWY vaccination program for teenagers in England, coverage among persons who left school in 2015, the first cohort to be vaccinated, was 36.6%. There were 69% fewer group W meningococcal cases than predicted by trend analysis and no cases in vaccinated teenagers.
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              Targeted vaccination of teenagers following continued rapid endemic expansion of a single meningococcal group W clone (sequence type 11 clonal complex), United Kingdom 2015.

              Rachel Campbell, V Saliba-Colombani, R Borrow … (2015)
              Since the epidemiological year 2009/10, the United Kingdom has experienced a year-on-year increase in meningococcal group W (MenW) disease due to rapid expansion of a single endemic hyper-virulent strain belonging to sequence type 11 clonal complex (cc). This strain was identified among cases diagnosed across all regions and was not linked to travel abroad. Consequently, an adolescent MenACWY conjugate vaccination programme for 13-18 year-olds will be introduced in August 2015, with priority given to 17-18 year-olds (school leavers).
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                Author and article information

                Journal
                Journal ID (nlm-ta): Euro Surveill
                Journal ID (iso-abbrev): Euro Surveill
                Journal ID (publisher-id): ES
                Title: Eurosurveillance
                Publisher: European Centre for Disease Prevention and Control (ECDC)
                ISSN (Print): 1025-496X
                ISSN (Electronic): 1560-7917
                Publication date (Print): 08 June 2017
                Volume: 22
                Issue: 23
                Electronic Location Identifier: 30549
                Affiliations
                [1 ]Department of Medical Microbiology, Meander Medical Centre, Amersfoort, the Netherlands
                [2 ]Public Health Service Region Utrecht, Zeist, the Netherlands
                [3 ]Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
                [4 ]Department of Surgery, Meander Medical Centre, Amersfoort, the Netherlands
                [5 ]Department of Intensive Care, Meander Medical Centre, Amersfoort, the Netherlands
                [6 ]Department of Medical Microbiology and the Netherlands Reference Laboratory for Bacterial Meningitis, Academic Medical Center, Amsterdam, the Netherlands
                Author notes

                Correspondence: Anne Russcher ( a.russcher@ 123456meandermc.nl )

                Article
                Publisher ID: 17-00325 Publisher ID: 30549
                DOI: 10.2807/1560-7917.ES.2017.22.23.30549
                PMC ID: 5479981
                PubMed ID: 28661395
                SO-VID: 015746cb-06d1-429c-a254-6e832bd54edc
                Copyright © This article is copyright of The Authors, 2017.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution (CC BY 4.0) Licence. You may share and adapt the material, but must give appropriate credit to the source, provide a link to the licence, and indicate if changes were made.

                History
                Date received : 14 May 2017
                Date accepted : 30 May 2017
                Categories
                Subject: Rapid Communication

                Keywords: meningococcal disease,emerging or re-emerging diseases,neisseria meningitidis,necrotising fasciitis
                Data availability:
                Keywords: meningococcal disease, emerging or re-emerging diseases, neisseria meningitidis, necrotising fasciitis

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