Background:
Invasive meningococcal disease (IMD), caused by Neisseria meningitidis is a rare but serious life-threatening infection. Public health IMD surveillance is needed to inform prevention strategies since there are regional and temporal variations in IMD incidence, age-group distributions, and serogroup distributions.
Methods:
National and multinational surveillance data from websites of public health agencies were reviewed to identify laboratory-confirmed IMD cases from 2015-2025. These data were used to determine national and regional IMD incidence, age-group distributions, and serogroup distributions. If more than one source was identified per country, local experts were consulted to determine the appropriate source. Non-English text was translated to English using Google Translate. Extracted data were confirmed through independent review, and results were summarized descriptively.
Results:
IMD surveillance data were identified from 87 countries in Africa (n = 23), the Americas (n = 14), Asia and Oceania (n = 11), and Europe (n = 39). Of the 87 countries with IMD surveillance data, 46 (52.9%) had age-group data and 59 (67.8%) had serogroup data. Most countries reported less than one IMD case per 100,000 population per year; the highest incidence was in Niger in 2015 during a large meningitis outbreak. In many countries, incidence declined during the COVID-19 pandemic period (2020-2021) before rebounding in the post-pandemic period (2022-2025). When age-group distributions were available, IMD incidence was highest in infants (children aged <1 year). Countries with ≥50% of IMD cases occurring in children in their most recent reporting year included: Belarus, Bulgaria, Croatia, Cyprus, Estonia, Greece, Hungary, Iceland, Kazakhstan, Lithuania, Romania, Slovakia, and South Africa. Based on the most recent reporting year, serogroups B, C, W, and Y were responsible for almost all cases worldwide. Serogroups C and W predominated in Africa, B and Y in the Americas, and B in Oceania and Europe. Notably, serogroup B remained a predominate serogroup in many countries despite available vaccines.
Discussion:
This study highlights the epidemiological diversity and burden of IMD worldwide and illuminates the need for public health surveillance for IMD and prevention strategies, including vaccination, aimed at reducing IMD burden.