Australian Meningococcal Surveillance Programme annual report, 2018

Invasive meningococcal disease (IMD) is a notifiable disease in Australia, and both probable and laboratory-confirmed cases of IMD are reported to the National Notifiable Diseases Surveillance System (NNDSS). In 2018, there were 281 IMD cases notified to the NNDSS. Of these, 278 were laboratory-confirmed cases analysed by the reference laboratories of the Australian National Neisseria Network (NNN). On investigation, the serogroup was able to be determined for 98.6% (274/278) of laboratory-confirmed cases. Serogroup B infections accounted for 44.2% of cases (123 cases); serogroup W for 36.3% of cases (101 cases); serogroup Y infections for 15.8% (44 cases) and serogroup C 1.4% (4 cases); and there were two unrelated cases (0.7%) of IMD attributable to serogroup E. Using molecular methods, 181/278 IMD cases were able to be typed. Of note was that 89% of typed serogroup W IMD cases (66/74) were porA antigen type P1.5,2; of this number, 44% (29/66) were sequence type 11, the hypervirulent strain reported in recent outbreaks in Australia and overseas. The primary age peak of IMD in Australia in 2018 was again observed in adults aged 45 years or more; a secondary disease peak was observed in children and infants aged less than 5 years. Serogroup B infections predominated in those aged less than 5 years, whereas serogroup W and serogroup Y infections predominated in those aged 45 years or more. Of the IMD isolates tested for antimicrobial susceptibility, 1.4% (3/210) were resistant to penicillin with an MIC ≥ 1 mg/L, and decreased susceptibility to penicillin was observed in a further 93.8% (197/210) of isolates. All isolates were susceptible to ceftriaxone and rifampicin; there was one isolate less susceptible to ciprofloxacin.