General Information and Epidemiology

There are five serogroups of Neisseria meningitidis: A, B, C, W135, and Y. The prevalence of the different types varies from country to country. There is currently no available vaccine against type B, but three other vaccines (A+C, C, and ACWY) are available. Overall, 10% of the UK population carry N. meningitidis (25% in the 15-19 age group) (59).

In the United Kingdom, most cases of meningitis are sporadic, with less than 5% occurring as clusters (outbreaks) amongst school children. Between 1996 and 2000, 59% of cases were group B, 36% were group C, and W135 and A accounted for 5%. There is a seasonal variation, with a high level of cases in winter and a low level in the summer. The greatest risk group are the under 5 year olds, with a peak incidence under 1 year old. A secondary peak occurs in the 15- to 19-year-old age group. In Sub-Saharan Africa, the disease is more prevalent in the dry season, but in many countries, there is background endemicity year-round. The most prevalent serogroup is A.

Routine vaccination against group C was introduced in the United Kingdom November 1999 for everybody up to the age of 18 years old and to all first-year university students. This has since been extended to include everyone under the age of 25 years old. As a result of the introduction of the vaccination program, there has been a 90% reduction of group C cases in those younger than under 18 years and an 82% reduction in those under 1 year old (60,61).

An outbreak of serogroup W135 meningitis occurred among pilgrims on the Hajj in 2000. Cases were reported from many countries, including the United Kingdom. In the United Kingdom, there is now an official requirement to be vaccinated with the quadrivalent vaccine (ACWY Vax) before going on a pilgrimage (Hajj or Umra), but illegal immigrants who have not been vaccinated may enter the country (62).

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