PMID- 30153883 OWN - NLM STAT- MEDLINE DCOM- 20190930 LR - 20220915 IS - 1560-7917 (Electronic) IS - 1025-496X (Print) IS - 1025-496X (Linking) VI - 23 IP - 34 DP - 2018 Aug TI - 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. LID - 10.2807/1560-7917.ES.2018.23.34.1700636 [doi] LID - 1700636 AB - 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. FAU - Miglietta, Alessandro AU - Miglietta A AD - Regional Health Agency of Tuscany, Epidemiologic Observatory, Florence, Italy. AD - Department of Infectious Diseases, Istituto Superiore di Sanita, Rome, Italy. AD - Units of Epidemiology and Preventive Medicine, Central Tuscany Health Authority, Florence, Italy. FAU - Fazio, Cecilia AU - Fazio C AD - Department of Infectious Diseases, Istituto Superiore di Sanita, Rome, Italy. AD - These authors contributed equally to this work. FAU - Neri, Arianna AU - Neri A AD - Department of Infectious Diseases, Istituto Superiore di Sanita, Rome, Italy. AD - These authors contributed equally to this work. FAU - Pezzotti, Patrizio AU - Pezzotti P AD - Department of Infectious Diseases, Istituto Superiore di Sanita, Rome, Italy. FAU - Innocenti, Francesco AU - Innocenti F AD - Regional Health Agency of Tuscany, Epidemiologic Observatory, Florence, Italy. FAU - Azzari, Chiara AU - Azzari C AD - Laboratory of Immunology and Infectious Diseases, Anna Meyer Children's University Hospital, University of Florence, Florence, Italy. FAU - Rossolini, Gian Maria AU - Rossolini GM AD - Department of Experimental and Clinical Medicine, University of Florence, and Clinical Microbiology and Virology Unit, Florence Careggi University Hospital, Florence, Italy. FAU - Moriondo, Maria AU - Moriondo M AD - Laboratory of Immunology and Infectious Diseases, Anna Meyer Children's University Hospital, University of Florence, Florence, Italy. FAU - Nieddu, Francesco AU - Nieddu F AD - Laboratory of Immunology and Infectious Diseases, Anna Meyer Children's University Hospital, University of Florence, Florence, Italy. FAU - Iannazzo, Stefania AU - Iannazzo S AD - Ministry of Health, Directorate-General of health prevention, Rome, Italy. FAU - D'Ancona, Fortunato AU - D'Ancona F AD - Department of Infectious Diseases, Istituto Superiore di Sanita, Rome, Italy. AD - Ministry of Health, Directorate-General of health prevention, Rome, Italy. FAU - Maraglino, Francesco Paolo AU - Maraglino FP AD - Ministry of Health, Directorate-General of health prevention, Rome, Italy. FAU - Guerra, Raniero AU - Guerra R AD - Ministry of Health, Directorate-General of health prevention, Rome, Italy. FAU - Rezza, Giovanni AU - Rezza G AD - Department of Infectious Diseases, Istituto Superiore di Sanita, Rome, Italy. FAU - Voller, Fabio AU - Voller F AD - Regional Health Agency of Tuscany, Epidemiologic Observatory, Florence, Italy. FAU - Stefanelli, Paola AU - Stefanelli P AD - Department of Infectious Diseases, Istituto Superiore di Sanita, Rome, Italy. LA - eng PT - Journal Article PL - Sweden TA - Euro Surveill JT - Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin JID - 100887452 RN - 0 (Meningococcal Vaccines) RN - 0 (serogroup C meningococcal conjugate vaccine) SB - IM MH - Adolescent MH - Adult MH - Aged MH - *Bisexuality MH - Carrier State/epidemiology MH - *Disease Outbreaks MH - Female MH - *Homosexuality, Male MH - Humans MH - Immunization Programs MH - Incidence MH - Italy/epidemiology MH - Male MH - Meningitis, Meningococcal/diagnosis/*epidemiology/microbiology/*prevention & control MH - Meningococcal Infections/diagnosis/*epidemiology MH - Meningococcal Vaccines/*administration & dosage/immunology MH - Neisseria meningitidis, Serogroup C/genetics/immunology/*isolation & purification MH - Serotyping MH - Vaccination/statistics & numerical data PMC - PMC6113744 OTO - NOTNLM OT - clusters OT - invasive meningococcal disease serogroup C OT - men who have sex with men (MSM) COIS- Conflict of interest: None declared. EDAT- 2018/08/30 06:00 MHDA- 2019/10/01 06:00 PMCR- 2018/08/23 CRDT- 2018/08/30 06:00 PHST- 2018/08/30 06:00 [entrez] PHST- 2018/08/30 06:00 [pubmed] PHST- 2019/10/01 06:00 [medline] PHST- 2018/08/23 00:00 [pmc-release] AID - 1700636 [pii] AID - 10.2807/1560-7917.ES.2018.23.34.1700636 [doi] PST - ppublish SO - Euro Surveill. 2018 Aug;23(34):1700636. doi: 10.2807/1560-7917.ES.2018.23.34.1700636.