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The changing face of meningococcal infection
1North Bristol NHS Trust, United Kingdom.
Abstract:
Menigococcal infection is caused by Neisseria meningitidis, a Gram negative diplococci. Invasive meningococcal disease (IMD) is caused by 6 capsular groups. The spectrum of infection is broad, with meningitis and meningococcal sepsis associated with a case fatality of between 4 and 20%. The main burden of disease is felt in the under 1's and this is where vaccination has been focused. Vaccination against MenC begun in 1999, with vaccines against Men ACWY and MenB added to the schedule in 2015. Over the last 1o years rates of IMD in the UK have fallen by over 50%. The impact of COVID-19 on cases has also been felt, with early data suggesting a significant drop in cases during the first wave in 2020. Despite the success of vaccination we need to remain vigilant. Clonal expansion of hypervirulent strains has been seen in epidemics and we have a significant proportion of the population who remain unvaccinated.
Insights
Invasive meningococcal disease (IMD) rates have decreased by over 50% in the UK due to vaccination efforts. Continued vigilance is necessary due to unvaccinated populations and potential hypervirulent strains.
Area of Science:
- Microbiology
- Epidemiology
- Immunology
Background:
- Invasive meningococcal disease (IMD) is caused by *Neisseria meningitidis*, a Gram-negative diplococcus responsible for meningitis and sepsis.
- IMD presents a significant mortality risk (4-20%), particularly impacting infants under one year old.
Purpose of the Study:
- To review the epidemiology and impact of vaccination on invasive meningococcal disease in the UK.
- To highlight the ongoing challenges and need for continued surveillance of *Neisseria meningitidis* infections.
Main Methods:
- Review of epidemiological data on IMD incidence in the UK.
- Analysis of vaccination schedules and their impact on disease reduction.
- Consideration of factors influencing current and future IMD trends.
Main Results:
- Rates of IMD in the UK have declined by over 50% in the past decade.
- Vaccination programs targeting MenC, MenACWY, and MenB have been instrumental in this reduction.
- Early data indicates a significant drop in IMD cases during the COVID-19 pandemic's initial wave.
Conclusions:
- Meningococcal vaccination has proven highly effective in reducing IMD burden in the UK.
- Sustained vigilance is crucial due to the presence of unvaccinated individuals and the potential for hypervirulent strain emergence.
