Laboratory confirmed cases of invasive meningococcal infection in England: April to June 2023
Updated 29 August 2024
Applies to England
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In England, the national UK Health Security Agency (UKHSA) Meningococcal Reference Unit (MRU) confirmed 86 cases of invasive meningococcal disease (IMD) between April and June 2023. Case numbers are less than in the equivalent period between April and June 2019, before pandemic restrictions were implemented in the UK. Cases in the intervening years were lower: 29 in the equivalent period in 2020, 17 in the equivalent period in 2021 and 55 in the equivalent period in 2022 (Table 1). Earlier reports on IMD cases in England are available ate: Meningococcal disease: guidance, data and analysis
Following 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 83.7% (72 of 86) of all cases, followed by MenW (5, 5.8%), MenY (5, 5.8%), MenC (3, 3.5%), and ungrouped/ungroupable (1, 1.2%) in this quarter in 2023. There were no confirmed cases for any other capsular groups.
There were 72 MenB cases confirmed between April and June 2023, compared to 48 cases, 15 cases, 22 cases, and 68 cases in the corresponding period in 2022, 2021, 2020 and 2019 (pre-pandemic), respectively. Between April and June 2023, MenB was responsible for 93.0% of IMD cases in individuals under 25 years of age and 74.4% of cases in individuals aged 25 years or older (Table 2). All 5 confirmed cases of MenW occurred in in individuals aged over 25 years, while 3 out of 5 MenY cases were reported in individuals aged over 25 years.
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Table 1. Invasive meningococcal disease in England by capsular group and laboratory testing method: April to June only, 2022 and 2023
| Capsular groups* | Culture and PCR (2022) | Culture and PCR (2023) | Culture only (2022) | Culture only (2023) | PCR only (2022) | PCR only (2023) | Total (2022 | Total (2023) |
|---|---|---|---|---|---|---|---|---|
| A | – | – | – | – | 1 | – | 1 | – |
| B | 7 | 11 | 10 | 21 | 31 | 40 | 48 | 72 |
| C | – | – | 1 | 1 | – | 2 | 1 | 3 |
| Ungrouped/ungroupable** | – | – | – | 1 | 2 | – | 2 | 1 |
| W | – | 1 | 2 | 4 | – | – | 2 | 5 |
| Y | – | – | 1 | 4 | – | 1 | 1 | 5 |
| Total | 7 | 12 | 14 | 31 | 34 | 43 | 55 | 86 |
*No cases of group E, X or Z were confirmed during the periods summarised in the table.
**Ungrouped or ungroupable refers to invasive clinical meningococcal isolates that were non-groupable, while ‘ungrouped’ cases refer to culture-negative but PCR screen (ctrA) positive and negative for the 4 genogroups (B, C, W and Y) routinely tested for.
Table 2. Invasive meningococcal disease in England by capsular group* and age group at diagnosis: April to June 2023
| Age groups | Capsular group B | Capsular group C | Capsular group W | Capsular group Y | Capsular group Other** | Total number | Total percentage |
|---|---|---|---|---|---|---|---|
| <1 year | 7 | – | – | 1 | – | 8 | 9.3% |
| 1 to 4 years | 5 | – | – | – | – | 5 | 5.8% |
| 5 to 9 years | 5 | – | – | 1 | 1 | 7 | 8.1% |
| 10 to 14 years | 3 | – | – | – | – | 3 | 3.5% |
| 15 to 19 years | 11 | – | – | – | – | 11 | 12.8% |
| 20 to 24 years | 9 | – | – | – | – | 9 | 10.5% |
| 25 to 44 years | 10 | – | – | 1 | – | 11 | 12.8% |
| 45 to 64 years | 15 | 2 | 1 | 1 | – | 19 | 22.1% |
| 65+ years | 7 | 1 | 4 | 1 | – | 13 | 15.1% |
| Total | 72 | 3 | 5 | 5 | 1 | 86 | 100% |
*No cases of group E, X or Z were confirmed during the period summarised in the table.
**‘Other’ includes group A and ungrouped or ungroupable. ‘Ungroupable’ refers to invasive clinical meningococcal isolates that were non-groupable, while ‘ungrouped’ cases refer to culture-negative but PCR screen (ctrA) positive and negative for the 4 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