Invasive Meningococcal Disease in Italy: from the analysis of national data to an evidence-based vaccination strategy.: Invasive Meningococcal Disease in Italy

Introduction. Invasive meningococcal disease (IMD) is one of the most severe vaccine-preventable diseases not yet under control. In Italy, although different anti-meningococcal vaccines are available, their offer among regions is heterogeneous. The aim of this study is to describe the epidemiology of IMD in Italy based on analysis of national surveillance data for 2011–2017 to optimize the vaccination strategy. Methods: IMD surveillance data from the Italian National Health Institute were analysed. Microsoft Excel was used to present trend analysis, stratifying by age and serogroups. Results: In Italy, during the period 2011–2017, the incidence of IMD increased from 0.25 cases/100,000 inhabitants in 2011 to 0.33 cases/100,000 in 2017. Most cases after 2012 were caused by non-B serogroups. The highest number of cases for the whole period occurred in people aged 25–64 years. The number of cases in those aged 25–64 years increased steadily after 2013 (36 cases in 2011, 79 in 2017), mostly due to non-B serogroups, representing more than 65% of cases in those aged 25+ years. Conclusions: In the period from 2011 to 2017, the incidence of IMDs increased in Italy. The increase, although probably due to better surveillance, highlights the high level of circulation of non-B serogroups and the importance of the disease in the adult population. Our analysis supports an anti-meningococcal vaccination plan in Italy that should include the highest number of preventable serogroups and be aimed at vaccinating the whole population through a multicohort strategy