Laboratory confirmed cases of invasive meningococcal infection in England: July to September 2023
Updated 26 September 2024
Applies to England
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In England, the national UK Health Security Agency (UKHSA) Meningococcal Reference Unit (MRU) confirmed 52 cases of invasive meningococcal disease (IMD) between July and September 2023. Case numbers are less than in the equivalent period between July and September 2019, before pandemic restrictions were implemented in the UK. Cases in the intervening years were lower: 26 in the equivalent period in 2020, 28 in the equivalent period in 2021 and 43 in the equivalent period in 2022 (Table 1).
Earlier reports on IMD cases in England are available at: Meningococcal disease: guidance, data and analysis
With the complete withdrawal of COVID-19 containment measures in England from July 2021, overall case numbers returned to pre-pandemic levels driven mainly by group B meningococcal disease (MenB). Cases due to the other capsular groups remained very low because of the highly effective indirect (herd) protection provided by the adolescent meningococcal ACWY (MenACWY) conjugate vaccine programme introduced in August 2015, alongside direct protection in those vaccinated (1).
The distribution of meningococcal cases by capsular group causing IMD is summarised in Table 1, with MenB accounting for 86.5% (45 of 52) of all cases, followed by MenY (3, 5.8%), MenW (2, 3.8%), and ungrouped or ungroupable (2, 3.8%) in this quarter in 2023. There were no confirmed cases for other capsular groups, including MenC.
There were 45 MenB cases confirmed between July and September 2023, compared to 38 cases, 23 cases, 20 cases, and 53 cases in the corresponding period in 2022, 2021, 2020 and 2019 (pre-pandemic), respectively. Between between July and September 2023, MenB was responsible for 91.2% of IMD cases in individuals under 25 years of age and 77.8% of cases in individuals aged 25 years or older (Table 2). Both the confirmed cases of MenW occurred in in individuals aged over 25 years, while 2 out of the 3 MenY cases were reported in individuals aged over 25 years.
The latest vaccine coverage information is available at Vaccine uptake guidance and the latest coverage data.
Table 1. Invasive meningococcal disease in England by capsular group and laboratory testing method: July to September only, 2022 and 2023
| Capsular groups [note 1] |
Culture and PCR (2022) | Culture and PCR (2023) | Culture only (2022) | Culture only (2023) | PCR only (2022) | PCR only (2023) | Total (2022 | Total (2023) |
|---|---|---|---|---|---|---|---|---|
| B | 8 | 10 | 9 | 14 | 21 | 21 | 38 | 45 |
| C | – | – | 1 | – | 1 | – | 2 | 0 |
| Ungrouped/ungroupable [note2] | 1 | – | – | 2 | – | – | 1 | 2 |
| W | 1 | – | – | 2 | – | – | 1 | 2 |
| Y | – | 2 | – | 1 | 1 | – | 1 | 3 |
| Total | 9 | 12 | 10 | 18 | 24 | 22 | 43 | 52 |
Note 1: No cases of group A, E, X or Z were confirmed during the periods summarised in the table
Note 2: Ungroupable refers to invasive clinical meningococcal isolates that were non-groupable, while ‘ungrouped’ refers to those that were culture-negative but PCR screen (ctrA) positive and negative for the four genogroups (B, C, W and Y) routinely tested for
Table 2. Invasive meningococcal disease in England by capsular group [note 3] and age group at diagnosis: July to September 2023
| Age groups | Capsular group B | Capsular group W | Capsular group Y | Capsular group ‘Other’ [note 4] | Total number | Total percentage |
|---|---|---|---|---|---|---|
| <1 year | 9 | – | – | – | 9 | 17.3% |
| 1 to 4 years | 3 | – | – | 1 | 4 | 7.7% |
| 5 to 9 years | 3 | – | – | – | 3 | 5.8% |
| 10 to 14 years | 3 | – | 1 | 1 | 5 | 9.6% |
| 15 to 19 years | 5 | – | – | – | 5 | 9.6% |
| 20 to 24 years | 8 | – | – | – | 8 | 15.4% |
| 25 to 44 years | 6 | – | – | – | 6 | 11.5% |
| 45 to 64 years | 3 | 1 | – | – | 4 | 7.7% |
| 65+ years | 5 | 1 | 2 | – | 8 | 15.4% |
| Total | 45 | 2 | 3 | 2 | 52 | 100% |
Note 3: No cases of other capsular groups were confirmed during the period summarised in the table
Note 4: ‘Other’ includes ungrouped or ungroupable isolates. ‘Ungroupable’ refers to invasive clinical meningococcal isolates that were non-groupable, while ‘ungrouped’ refers to those that were culture-negative but PCR screen (ctrA) positive and negative for the four genogroups (B, C, W and Y) routinely tested for
References
1. Campbell H and others, ‘Impact of an adolescent meningococcal ACWY immunisation programme to control a national outbreak of group W meningococcal disease in England: a national surveillance and modelling study’ Lancet Child Adolescent Health 2022: volume 6, issue 2