Published: 06.10.05 Updated: 07.10.2005 09:32:16
Hans Blystad, Lars Blad, Johan Giesecke, Swedish Institute for Infectious Disease Control, Sweden, the Steering Group of the project Building a Network for Infections Disease Surveillance in the Baltic Sea Region
Meningococcal disease is a notifiable disease in all countries of the region. All countries report cases of both meningitis and septicaemia.
During the last 20 years the incidence rates of reported meningococcal disease have been relatively stable with incidence rates usually below 5 per 100 000 population. Except for Iceland, infection with serogroup B dominates in the region, followed by infection with serogroup C. In the last two years meningococcal infection caused by serogroup C has dominated in Iceland. In the early 2000s an epidemic 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 predominating groups for contracting meningococcal disease are children below 5 years of age and teenagers between 15-19 years of age.
Only Iceland has so far introduced the new conjugate vaccines against group C meningococcal disease in its national immunisation programme. In most of the region, vaccines against serogroup A and/or C are only given in case of clusters and outbreaks. The vaccine against serogroup B developed in Norway has not been implemented in the national immunisation 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 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.