Epidemiology of invasive meningococcal disease in the Netherlands and impact of serogroup C vaccination

• National surveillance data (Netherlands Reference Laboratory for Bacterial Meningitis (NRLBM); 1960-2012):N=15,412 cases of culture-positive invasive meningococcal disease (CSF: 56% − blood only: 5% − CSF + blood: 19%)

• 1999-2001: serogroup C epidemic → 2002: introduction of serogroup C conjugate vaccination at age 14 mo

Bijlsma MW et al. Lancet Infect Dis 2014;14:805-12

1 of 2

Epidemiology of invasive meningococcal disease in the Netherlands and impact of serogroup C vaccination

• 2003: emergence of serogroup Y + disappearance of serogroup A disease

• Evidence of meningococcal capsular switching, but not of serogroup replacement

• Isolates with reduced penicillin susceptibility: 1993: 0.9% → 2012: 37%Isolates with penicillin resistance: none

Large-scale vaccination with a meningococcal C conjugate vaccine has resulted in the near disappearance of serogroup C invasive

meningococcal disease in the Netherlands

Bijlsma MW et al. Lancet Infect Dis 2014;14:805-12

2 of 2

Association between psychological stress and herpes zoster (HZ)

• Retrospective database analysis (medical claims data from Truven Health MarketScan® Commercial Databases, USA, 2002-2011): N=39,811 adults ≥25 yr experiencing acute psychological stress, i.e abrupt death or catastrophic health event occurring in previously healthy spouse

• Self-controlled case series method: compare HZ events during 3-mo risk window following stress to 3-mo control window (day 120-31) prior to stress:Assess:

– Incidence (number of episodes)

– % of all outpatient healthcare (HC) services → control for changes in health seeking behaviour that might occur in persons experiencing stress

Positive control: mental health visits: comparison risk vs control window

Harpaz R. IDWeek 2014 abs. 1130

1 of 2

Data from poster

• Incidence (RI: relative incidence)

• % of all outpatient healthcare services (RR: relative risk)

Association between psychological stress and herpes zoster (HZ)

Psychological stress does not seem to be a risk factor for HZ in adults

Harpaz R. IDWeek 2014 abs. 1130

2 of 2

Data from poster