{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:22:41Z","timestamp":1789690961948,"version":"4.0.1"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2019,8,15]],"date-time":"2019-08-15T00:00:00Z","timestamp":1565827200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,8,15]],"date-time":"2019-08-15T00:00:00Z","timestamp":1565827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Clin Microbiol Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"DOI":"10.1007\/s10096-019-03668-y","type":"journal-article","created":{"date-parts":[[2019,8,15]],"date-time":"2019-08-15T06:14:12Z","timestamp":1565849652000},"page":"2197-2203","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Epidemiology of invasive meningococcal disease in Greece, 2006\u20132016"],"prefix":"10.1007","volume":"38","author":[{"name":"Members of the Hellenic network for Invasive meningococcal disease","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Flountzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theano","family":"Georgakopoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sooria","family":"Balasegaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Kesanopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasia","family":"Xirogianni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Papandreou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Tzanakaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,8,15]]},"reference":[{"issue":"8","key":"3668_CR1","doi-asserted-by":"publisher","first-page":"1220","DOI":"10.1093\/cid\/ciy257","volume":"67","author":"Tamazoust Guiddir","year":"2018","unstructured":"Guiddir T, Gros M, Hong E, Terrade A, Denizon M, Deghmane AE, Taha MK (2018) Unusual initial abdominal presentations of invasive meningococcal disease. Clin Infect Dis. \nhttps:\/\/doi.org\/10.1093\/cid\/ciy257.","journal-title":"Clinical Infectious Diseases"},{"issue":"18","key":"3668_CR2","doi-asserted-by":"publisher","first-page":"1378","DOI":"10.1056\/NEJM200105033441807","volume":"344","author":"NE Rosenstein","year":"2001","unstructured":"Rosenstein NE, Perkins BA, Stephens DS, Popovic T, Hughes JM (2001) Meningococcal disease. N Engl J Med 344(18):1378\u20131388","journal-title":"N Engl J Med"},{"key":"3668_CR3","doi-asserted-by":"publisher","first-page":"566","DOI":"10.3201\/eid1904.111799","volume":"19","author":"OB Harrison","year":"2013","unstructured":"Harrison OB, Claus H, Jiang Y, Bennett JS, Bratcher HB, Jolley KA et al (2013) Description and nomenclature of Neisseria meningitidis capsule locus. Emerg Infect Dis J 19:566. \nhttps:\/\/doi.org\/10.3201\/eid1904.111799","journal-title":"Emerg Infect Dis J"},{"issue":"10","key":"3668_CR4","doi-asserted-by":"publisher","first-page":"1477","DOI":"10.1586\/erv.11.117","volume":"10","author":"P Kriz","year":"2011","unstructured":"Kriz P, Wieffer H, Holl K, Rosenlund M, Budhia S, Vyse A (2011) Changing epidemiology of meningococcal disease in Europe from the mid-20th to the early 21st century. Expert Rev Vaccines 10(10):1477\u20131486","journal-title":"Expert Rev Vaccines"},{"issue":"5","key":"3668_CR5","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s00431-012-1924-0","volume":"172","author":"M Knuf","year":"2013","unstructured":"Knuf M, Romain O, Kindler K et al (2013) Immunogenicity and safety of the quadrivalent meningococcal serogroups a, C, W-135 and Y tetanus toxoid conjugate vaccine (MenACWY-TT) in 2-10-year-old children: results of an open, randomised, controlled study. Eur J Pediatr 172(5):601\u2013612","journal-title":"Eur J Pediatr"},{"issue":"7","key":"3668_CR6","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1016\/S1473-3099(17)30170-6","volume":"17","author":"SR Parikh","year":"2017","unstructured":"Parikh SR, Newbold L, Slater S, Stella M, Moschioni M et al (2017) Meningococcal serogroup B strain coverage of the multicomponent 4CMenB vaccine with corresponding regional distribution and clinical characteristics in England, Wales, and Northern Ireland, 2007-08 and 2014-15: a qualitative and quantitative assessment. Lancet Infect Dis 17(7):754\u2013762","journal-title":"Lancet Infect Dis"},{"issue":"16","key":"3668_CR7","doi-asserted-by":"publisher","first-page":"2034","DOI":"10.1016\/j.vaccine.2017.03.007","volume":"35","author":"R Whittaker","year":"2017","unstructured":"Whittaker R, Dias JG, Ramliden M, K\u00f6dm\u00f6n C, Economopoulou A, Beer N (2017) Pastore Celentano L; ECDC network members for invasive meningococcal disease. The epidemiology of invasive meningococcal disease in EU\/EEA countries, 2004-2014. Vaccine 35(16):2034\u20132041","journal-title":"Vaccine"},{"issue":"5","key":"3668_CR8","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1111\/j.1469-0691.2007.01704.x","volume":"13","author":"DA Kafetzis","year":"2007","unstructured":"Kafetzis DA, Stamboulidis KN, Tzanakaki G, Kourea Kremastinou J, Skevaki CL, Konstantopoulos A, Tsolia M (2007) Meningococcal group C disease in Greece during 1993-2006: the impact of an unofficial single-dose vaccination scheme adopted by most paediatricians. Clin Microbiol Infect 13(5):550\u2013552","journal-title":"Clin Microbiol Infect"},{"issue":"1","key":"3668_CR9","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1080\/21645515.2016.1230577","volume":"13","author":"T Georgakopoulou","year":"2017","unstructured":"Georgakopoulou T, Menegas D, Katsioulis A, Theodoridou M, Kremastinou J, Hadjichristodoulou C (2017) A cross-sectional vaccination coverage study in preschool children attending nurseries-kindergartens: implications on economic crisis effect. Hum Vaccin Immunother 13(1):190\u2013197","journal-title":"Hum Vaccin Immunother"},{"issue":"6","key":"3668_CR10","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1016\/j.vaccine.2005.07.058","volume":"24","author":"G Tzanakaki","year":"2006","unstructured":"Tzanakaki G, Markou F, Kesanopoulos K, Levidiotou S, Pangalis A, Tsolia M et al (2006) Phenotypic assessment of Neisseria meningitidis isolates obtained from patients with invasive meningococcal disease in Greece, 1993-2003: implications for serogroup B vaccines based on PorA serosubtype antigens. Vaccine 24(6):819\u2013825","journal-title":"Vaccine"},{"issue":"5","key":"3668_CR11","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1111\/j.1469-0691.2005.01109.x","volume":"11","author":"G Tzanakaki","year":"2005","unstructured":"Tzanakaki G, Tsopanomichalou M, Kesanopoulos K, Matzourani R, Sioumala M, Tabaki A, Kremastinou J (2005) Simultaneous single-tube PCR assay for the detection of Neisseria meningitidis, Haemophilus influenzae type b and Streptococcus pneumoniae. Clin Microbiol Infect 11(5):386\u2013390","journal-title":"Clin Microbiol Infect"},{"key":"3668_CR12","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1111\/j.1574-695X.2008.00406.x","volume":"53","author":"Z Drakopoulou","year":"2008","unstructured":"Drakopoulou Z, Kesanopoulos K, Sioumala M, Tambaki A, Kremastinou J, Tzanakaki G (2008) Simultaneous single-tube PCR-based assay for the direct identification of the five most common meningococcal serogroups from clinical samples. FEMS Immunol Med Microbiol 53:178","journal-title":"FEMS Immunol Med Microbiol"},{"issue":"6","key":"3668_CR13","doi-asserted-by":"publisher","first-page":"3140","DOI":"10.1073\/pnas.95.6.3140","volume":"95","author":"MC Maiden","year":"1998","unstructured":"Maiden MC, Bygraves JA, Feil E, Morelli G, Russell JE, Urwin R (1998) Et. al. multilocus sequence typing: a portable approach to the identification of clones within populations of pathogenic microorganisms. Proc Natl Acad Sci U S A 95(6):3140\u20133145","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"4","key":"3668_CR14","doi-asserted-by":"publisher","first-page":"674","DOI":"10.3201\/eid1004.030247","volume":"10","author":"JE Russell","year":"2004","unstructured":"Russell JE, Jolley KA, Feavers IM, Maiden MC, Suker J (2004) PorA variable regions of Neisseria meningitidis. Emerg Infect Dis 10(4):674\u2013678","journal-title":"Emerg Infect Dis"},{"issue":"Pt 7","key":"3668_CR15","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1099\/mic.0.26131-0","volume":"149","author":"EA Thompson","year":"2003","unstructured":"Thompson EA, Feavers IM, Maiden MC (2003) Antigenic diversity of meningococcal enterobactin receptor FetA, a vaccine component. Microbiology 149(Pt 7):1849\u20131858","journal-title":"Microbiology"},{"key":"3668_CR16","unstructured":"European Centre for Disease Prevention and Control. Surveillance Atlas for Infectious Diseases. \nhttps:\/\/atlas.ecdc.europa.eu\/public\/index.aspx"},{"issue":"2 Suppl","key":"3668_CR17","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.jadohealth.2016.04.012","volume":"59","author":"SI Pelton","year":"2016","unstructured":"Pelton SI (2016) The global evolution of meningococcal epidemiology following the introduction of meningococcal vaccines. J Adolesc Health 59(2 Suppl):S3\u2013S11","journal-title":"J Adolesc Health"},{"issue":"11","key":"3668_CR18","doi-asserted-by":"publisher","first-page":"1334","DOI":"10.1016\/S1473-3099(15)00217-0","volume":"15","author":"S Sridhar","year":"2015","unstructured":"Sridhar S, Greenwood B, Head C, Plotkin SA, S\u00e1fadi MA, Saha S, Taha MK et al (2015) Global incidence of serogroup B invasive meningococcal disease: a systematic review. Lancet Infect Dis 15(11):1334\u20131346","journal-title":"Lancet Infect Dis"},{"issue":"10","key":"3668_CR19","doi-asserted-by":"publisher","first-page":"e473","DOI":"10.1016\/S2468-2667(17)30157-3","volume":"2","author":"MJ Knol","year":"2017","unstructured":"Knol MJ, Hahn\u00e9 SJM, Lucidarme J, Campbell H, de Melker HE, Gray SJ, Borrow R et al (2017t) Temporal associations between national outbreaks of meningococcal serogroup W and C disease in the Netherlands and England: an observational cohort study. Lancet Public Health 2(10):e473\u2013e482","journal-title":"Lancet Public Health"},{"issue":"4","key":"3668_CR20","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1093\/cid\/ciu881","volume":"60","author":"SN Ladhani","year":"2015","unstructured":"Ladhani SN, Beebeejaun K, Lucidarme J, Campbell H, Gray S, Kaczmarski E, Ramsay ME, Borrow R (2015) Increase in endemic Neisseria meningitidis capsular group W sequence type 11 complex associated with severe invasive disease in England and Wales. Clin Infect Dis 60(4):578\u2013585","journal-title":"Clin Infect Dis"},{"issue":"14","key":"3668_CR21","doi-asserted-by":"publisher","first-page":"1800245","DOI":"10.2807\/1560-7917.ES.2019.24.14.1800245","volume":"24","author":"M Krone","year":"2019","unstructured":"Krone M, Gray S, Abad R, Skoczy\u0144ska A, Stefanelli P, van der Ende A, Tzanakaki G et al (2019) Increase of invasive meningococcal serogroup W disease in Europe, 2013 to 2017. Euro Surveill 24(14):1800245. \nhttps:\/\/doi.org\/10.2807\/1560-7917.ES.2019.24.14.1800245","journal-title":"Euro Surveill"},{"issue":"9","key":"3668_CR22","doi-asserted-by":"publisher","first-page":"2281","DOI":"10.1080\/21645515.2015.1051276","volume":"11","author":"Michael Br\u00f6ker","year":"2015","unstructured":"Br\u00f6ker M, Emonet S, Fazio C, Jacobsson S, Koliou M, Kuusi M et al (2015) Meningococcal serogroup Y disease in Europe: continuation of high importance in some European regions in 2013. Hum Vaccin Immunother 11(9):2281\u20132286. \nhttps:\/\/doi.org\/10.1080\/21645515.2015.1051276.","journal-title":"Human Vaccines & Immunotherapeutics"},{"issue":"26","key":"3668_CR23","doi-asserted-by":"publisher","first-page":"3876","DOI":"10.1016\/j.vaccine.2018.02.038","volume":"36","author":"SR Parikh","year":"2018","unstructured":"Parikh SR, Campbell H, Gray SJ, Beebeejaun K, Ribeiro S, Borrow R, Ramsay ME, Ladhani SN (2018) Epidemiology, clinical presentation, risk factors, intensive care admission and outcomes of invasive meningococcal disease in England, 2010-2015. Vaccine 36(26):3876\u20133881","journal-title":"Vaccine"},{"issue":"3","key":"3668_CR24","doi-asserted-by":"publisher","first-page":"e0150721","DOI":"10.1371\/journal.pone.0150721","volume":"11","author":"Raquel Abad","year":"2016","unstructured":"Abad R, Medina V, Stella M, Boccadifuoco G, Comanducci M, Bambini S, Muzzi A, V\u00e1zquez JA (2016) Predicted strain coverage of a new meningococcal multicomponent vaccine (4CMenB) in Spain: analysis of the differences with other European countries. PLoS One 11(3):e0150721","journal-title":"PLOS ONE"},{"key":"3668_CR25","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1186\/1471-2180-14-111","volume":"14","author":"G Tzanakaki","year":"2014","unstructured":"Tzanakaki G, Hong E, Kesanopoulos K, Xirogianni A, Bambini S, Orlandi L, Comanducci M, Muzzi A, Taha MK (2014) Diversity of Greek meningococcal serogroup B isolates and estimated coverage of the 4CMenB meningococcal vaccine. BMC Microbiol 14:111. \nhttps:\/\/doi.org\/10.1186\/1471-2180-14-111","journal-title":"BMC Microbiol"},{"issue":"1","key":"3668_CR26","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1111\/j.1574-695X.1999.tb01716.x","volume":"23","author":"J Kremastinou","year":"1999","unstructured":"Kremastinou J, Tzanakaki G, Kansouzidou A, Pagalis A, Danielides V, Kouppari G et al (1999) Recent emergence of serogroup C meningococcal disease in Greece. FEMS Immunol Med Microbiol 23(1):49\u201355","journal-title":"FEMS Immunol Med Microbiol"},{"issue":"9","key":"3668_CR27","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1099\/jmm.0.000320","volume":"65","author":"S Bukovski","year":"2016","unstructured":"Bukovski S, Vacca P, Anselmo A, Knezovic I, Fazio C, Neri A et al (2016) Molecular characterization of a collection of Neisseria meningitidis isolates from Croatia, June 2009 to January 2014. J Med Microbiol 65(9):1013\u20131019","journal-title":"J Med Microbiol"},{"issue":"12","key":"3668_CR28","doi-asserted-by":"publisher","first-page":"e0167762","DOI":"10.1371\/journal.pone.0167762","volume":"11","author":"Z Jandova","year":"2016","unstructured":"Jandova Z, Musilek M, Vackova Z, Kozakova J, Krizova P (2016) Serogroup and clonal characterization of Czech invasive Neisseria meningitidis strains isolated from 1971 to 2015. PLoS One 11(12):e0167762","journal-title":"PLoS One"},{"issue":"6","key":"3668_CR29","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1016\/j.jinf.2017.02.011","volume":"74","author":"I. Parent du Chatelet","year":"2017","unstructured":"Parent du Chatelet I, Deghmane AE, Antona D, Hong E, Fonteneau L, Taha MK, L\u00e9vy-Bruhl D (2017 Jun) Characteristics and changes in invasive meningococcal disease epidemiology in France, 2006-2015. J Inf Secur 74(6):564\u2013574. \nhttps:\/\/doi.org\/10.1016\/j.jinf.2017.02.011","journal-title":"Journal of Infection"},{"key":"3668_CR30","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1128\/AAC.00207-18","volume":"62","author":"P Vacca","year":"2018","unstructured":"Vacca P, Fazio C, Neri A, Ambrosio L, Palmieri A, Stefanelli P (2018) Neisseria meningitidis antimicrobial resistance in Italy, 2006 to 2016. AAC 62:9","journal-title":"AAC"}],"container-title":["European Journal of Clinical Microbiology & Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-019-03668-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s10096-019-03668-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s10096-019-03668-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,8,13]],"date-time":"2020-08-13T23:31:13Z","timestamp":1597361473000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s10096-019-03668-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8,15]]},"references-count":30,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["3668"],"URL":"https:\/\/doi.org\/10.1007\/s10096-019-03668-y","relation":{},"ISSN":["0934-9723","1435-4373"],"issn-type":[{"value":"0934-9723","type":"print"},{"value":"1435-4373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8,15]]},"assertion":[{"value":"15 June 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 August 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"Ethic approval was not required since depersonalized data from notifiable disease registry and laboratory findings were used.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics statements"}},{"value":"The authors declare that they have no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}