Published: 09.02.05 Updated: 09.02.2005 18:21:10
Meningococcal disease is a notifiable disease in the entire region. Northwest Russia, Estonia and Sweden report laboratory confirmed cases, cases with typical clinical picture without laboratory confirmation and cases epidemiologically linked to a laboratory confirmed case. Denmark, Norway and Lithuania report both laboratory confirmed cases and cases with typical clinical picture without laboratory confirmation. Finland and Iceland only report laboratory confirmed cases. Cases of non-invasive meningococcal disease (like pharyngitis) are included in the reported figures from Northwest Russia.
Figure 29. Number of cases of meningococcal disease notified in 2003 per 100 000 population (1).
During the last years the incidence rates of reported meningococcal disease in most of the countries have been relatively stable with incidence rates usually below 5 per 100 000 population (figure 30). Except for Iceland, infection with serogroup B dominates in the region, followed by infection with serogroup C. In the early 2000s an increase in cases caused by serogroup C was observed in Iceland. Following a vaccination campaign aimed at children and youths below 19 years of age, the incidence of meningococcal disease group C has fallen in Iceland. In the early 2000s an increase in cases caused by serogroup W135 among travellers returning from the haj pilgrimage to Mecca or their close contacts were seen in many countries in the western part of the region.
The predominant groups for contracting meningococcal disease are children below 5 years of age and teenagers between 15-19 years of age.
Figure 30. Number of cases of meningococcal disease notified per 100 000 population 1999- 2003 by groups of countries or regions (1). Komi, Pskov, Novgorod and Vologda regions not included.
Only Iceland has so far introduced the new conjugate vaccine against group C meningococcal disease in the national vaccination programme. In most of the region, vaccines against serogroup A and C are only given following a cluster of cases. The vaccine against serogroup B developed in Norway has not been introduced in the national vaccination programme due to the decline in incidence of serogroup B in Norway.
To avoid secondary cases of meningococcal disease, all the countries in the region with the exception of Norway, undertake carriage eradication of close contacts in all cases of meningococcal disease. In Norway, penicillin is given to close contacts that may have been exposed to the same carrier as the index case, and carriage eradication is implemented only in cases of clusters or outbreaks.