| In a nutshell |
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| ● Meningococcal disease surveillance data for the 2021-22 season are shown, provided by the National Center for Epidemiology ● After the drop in incidence in the first two years of the pandemic, in 2021-22 an increase is observed ● In the 2021-22 season, 108 cases (0.23/100,000) were registered for all serogroups. MenB caused 45 cases (0.1/100,000), MenC 3 cases, MenW 6, and MenY 5. ● In the group of children under 1 year of age, the rate found was 3.05/100,000; in 1-4 years, 0.52/100,000; and in the 15-19 year old, 0.24/100,000. ● The provisional data of what has elapsed in the current season, 2022-23, show an increase in the incidence, in line with what was observed in the previous season. Until week 6/2023, 29 cases have been reported, while in the same period of the previous season, 2021-22, there were 14 and in the previous one, 2020-21, only 8 cases. ● The incorporation of vaccination against MenB in the childhood vaccination schedules of the communities has the potential to alleviate or change the increasing trend of the incidence observed in the last two seasons. |
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Introduction
The epidemiological season of invasive meningococcal disease (IMD) 2021-22 began week 41/2021 (October 11, 2021) and has ended week 40/2022 (which ended on October 3, 2022).
Below is a graphic representation of the provisional data published by the National Epidemiology Center (CNE, Carlos III Health Institute) through the Weekly Epidemiological Bulletin online (reports no. 42 and 43 of 2022) corresponding to the 2021-22 season. It also shows a preview of the provisional data for the current season, 2022-23, up to week 4/2023 (in report no. 6 of 2023).
Until December 2022, only five autonomous communities (Castilla y León, the Canary Islands, Andalusia, Catalonia and Galicia) had included universal vaccination against serogroup B meningococcus with 4CMenB in infants in their first year of life. Vaccinations and the Public Health Commission (Ministry of Health) recommended the incorporation of this vaccine in the “Lifetime Vaccination Calendar”, a measure that, finally, the Interterritorial Council of the SNS approved in December 2022. There are currently eleven communities that have already started this vaccination.
Evolution of EMI between the 2010-11 and 2021-22 seasons, according to the different serogroups
The graph above shows a general overview of the evolution of the rates (cases per 100.000 inhabitants) of Spain as a whole between the 2010-11 seasons and the last one, 2021-22, which ended in October 2022.
The extraordinary impact of the covid pandemic that began in the middle of the meningococcal surveillance season is observed. This phenomenon and its possible causes have been commented on on this website and also by the National Epidemiology Center itself (Soler Soneira M, Bol Epidemiol Sem 2022).
After the drop in incidence in 2019-20 and 2020-21, it can be seen that in the 2021-22 season there has been a notable increase in the incidence of IMD.
Meningococcal disease in Spain, 2021-22 season
Number of cases and rates, by autonomous community
Rates according to autonomous communities and serogroups
Serogroup B is the most frequently identified cause of IMD: it constitutes 41.7% of all cases (N=108, including all serogroups, non-typeable, other serogroups, unknown, and suspicions), 45% of cases of confirmed IMD and 76.3% of the cases with a known serogroup.
Rates according to age groups and serogroups
Children under 1 year of age are the age group with the highest rate of IMD: 10 cases per serogroup B (rate of 3.05/100.000) and one case per serogroup C (rate of 0.3/100.000) (week 4/2023, provisional data).
The next most important age group is 1-4 years: 8 cases for serogroup B (rate of 0.52/100.000). Next, the group of 15-19 years: 6 cases by serogroup B (rate of 0.24/100.000) and one per serogroup W (rate of 0.04/100.000).
Serogroup B: increase in cases (preview of the first data for the 2022-23 season)
The following graphs show the evolution of the incidence of IMD by serogroup B and an advance in the number of cases and rates up to week 4 of 2023 (report no. 6/2023 of the BES of the CNE) by the same serogroup. Both the data for 2021-22 and 2022-23 are provisional data, pending confirmation by the CNE.
The first graph shows the number of cases and rates up to the week 6 report of the last and current seasons, 2022-23. The effect of the pandemic is observed and a recovery in the number of cases from 2020-21, which registered the lowest number (n=8), to 14 cases in 2021-22 and 29 cases so far in the 2022-23 season. (until week 4-2023).
The following graph shows the same data (number of cases from the start of the season to the week 6 report of the following year) compared to the number of data for the full season in the last 5 seasons (2021 data -22 and 2022-23 are provisional).
It can be deduced from the data shown that it could be expected that, if the same epidemiological conditions are maintained, a significant number of new cases will be registered until the end of the current season. However, considering that 11 autonomous communities have already undertaken universal vaccination of infants from two months of age, we hope that the previous prediction will not materialize.
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