Is group C meningococcal disease increasing in Europe? A report of surveillance of meningococcal infection in Europe 1993–6
A surveillance system to assess the impact and changing epidemiology of invasive meningococcal disease in Europe was set up in 1987. Since about 1991, contributors from national reference laboratories, national communicable disease surveillance centres and institutes of public health in 35 European countries provided information on all reported cases of meningococcal disease in their country. We describe some trends observed over the period 1993–6. The main findings were: the overall incidence of meningococcal disease was 1·1 per 100000 population but there was some evidence of a slow increase over time and with northern European countries tending to have a higher incidence (Kendall correlation 0·5772, P<0·001), an increasing predominance of serogroup C, and a shift in the age distribution towards teenagers and away from younger children (χ2 test for trend 44·56, P<0·0001), although about half of the cases were under 5 years of age. The overall case fatality rate was 8·3% and the most common serosubtypes were B[ratio]15[ratio]P1.7,16 and C[ratio]2a[ratio]P1.2,5.(Accepted August 21 1998)
c1 Author for correspondence: Public Health Laboratory Service, Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ.
1 ON BEHALF OF THE EUROPEAN MENINGITIS SURVEILLANCE GROUP. The reporting members of this group are: E. Mastori, Albania; W. Thiel, Austria; P. Andre, Belgium; I. Haydouchka, Bulgaria; Yu Xuing, China; B. Borcic, Croatia; M. S. Hernandaz, Cuba; P. Kriz-Kuzemenska, Czech Republic; I. Lind, Denmark; E. Hansen, Denmark; N. Begg, England & Wales; L. Thornton, Republic of Ireland; F. Ryan, Republic of Ireland; J. Fogarty, Republic of Ireland; U. Joks, Estonia; T. Leino, Finland; H. Kayhty, Finland; J. Riou, France; H. Sonntag, Germany; A. Vass, Hungary; G. Tzanakaki, Greece; J. Kremastinou, Greece; H. Hardardottir, Iceland; K. Jonsdottir, Iceland; C. Block, Israel; S. Salmaso, Italy ; P. Mastrantonio, Italy; A. Griskevica, Latvia; R. Mikulkiene, Lithuania; H. Agius-Muscat, Malta; L. Spanjaard, Netherlands; K. van Wijngaarden, Netherlands; E. Mitchell, Northern Ireland; S. Aasen, Norway; B. G. Iversen, Norway; J. Zabicka, Poland; A. Leitao, Portugal; I. Levenet, Romania; I. Korolyova, Russia; Alexander Platonov, Moscow; L. E. Smart, Scotland; M. Slacikova, Slovak Republic; A. Kraigher, Slovenia; J. Vazquez, Spain; P. Olcén, Sweden; V. Romanus, Sweden; S. Winteler, Switzerland; P. Helbling, Switzerland; G. Kabaday, Turkey; M. S. Ensari, Turkey; L. R. Schostakovitch-Koretskaya, Ukraine. J. Tapsall (Australia) and D. Martin (New Zealand) also contributed to this surveillance.