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Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease) Number of BacMen Notifications 600 500 400 300 200 100 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Meningo 536 515 330 253 237 198 203 209 179 168 147 114 Other BacMen 51 75 66 47 77 70 68 83 80 87 82 68 CIR Meningo 14.8 13.1 8.4 6.5 6.1 4.7 4.8 4.9 4.2 4.0 3.5 2.7 CIR Other BacMen 1.4 1.9 1.7 1.2 2.0 1.7 1.6 2.0 1.9 2.1 1.9 1.6 Year 16 14 12 10 8 6 4 2 0 Rate per 100,000 total population Figure 5.2. Number of invasive meningococcal disease and other bacterial notifications in Ireland, 1999-2010 5.5. Invasive Meningococcal Disease (IMD) 5.5.1. IMD cases The incidence of IMD increased from 12.4 per 100,000 total population in 1997 and 1998 to 14.8 per 100,000 in 1999. It dropped to 13.1 per 100,000 in 2000 and steadily declined each year after that until it reached 4.7 per 100,000 in 2004. In 2005 and 2006, incidence rates increased very slightly to 4.8 and 4.9 per 100,000, respectively. More recently in 2010, the incidence rate has fallen further to 2.7 per 100,000 (Figure 5.3). Between 1999 and 2010, N. meningitidis serogroups B and C accounted for over 96% of all confirmed cases in Ireland (n=2474/2562) (Table 5.1). Similar to total IMD, the incidence of serogroup B IMD also peaked in 1999 (8.0/100,000 total population). Since then the annual incidence rates have declined somewhat but the magnitude of this decrease has not been the same as that seen for total IMD. The annual incidence rates of serogroup C disease did not fluctuate greatly between 1999-2000, with an average annual rate of 3.6 per 100,000 total population reported. However, since the introduction of the meningococcal group C conjugate (MenC) vaccine in October 2000, the incidence rates of serogroup C disease have plummeted in Ireland with 0.1 cases per 100,000 total population occurring annually on average over the last eight years, 2003-2010 (Figure 5.3). Crude Incidence Rate per 100,000 16 MenC vaccine introduced 14 12 10 8 6 4 2 0 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Total 14.8 13.1 8.4 6.5 6.1 4.7 4.8 4.9 4.2 4.0 3.5 2.7 Serogroup B 8.1 6.6 6.3 5.1 5.3 3.8 4.0 4.0 3.7 3.5 2.8 2.2 Serogroup C 3.7 3.5 0.9 0.4 0.1 0.1 0.1 0.1 0.0 0.1 0.1 0.1 Year Figure 5.3. Crude incidence rates of invasive meningococcal disease in Ireland, 1999-2010 -44-
Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease) Table 5.1. Annual number of IMD notifications by serogroup, 1999-2010 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Serogroup B 292 258 245 199 206 163 169 168 157 149 119 93 Serogroup C 135 139 35 14 5 5 5 4 2 4 5 4 Serogroup W 135 4 3 3 6 3 1 3 1 2 2 2 1 Serogroup Y 2 4 1 2 2 2 3 4 0 1 4 0 Non-groupable (NG) 12 6 7 1 4 1 2 1 0 1 0 0 No organism detected 91 105 39 31 17 26 21 31 18 11 17 16 Total 536 515 330 253 237 198 203 209 179 168 147 114 CIR* 14.8 13.1 8.4 6.5 6.1 5.1 4.8 4.9 4.2 4.0 3.5 2.7 * Overall crude incidence rate per 100,000 total population IMD by gender and age Between 1999 and 2010, a total of 3,089 cases of IMD were notified. More cases occurred in males (55.0%) than in females, giving a male to female ratio of 1.2:1.0. The peak age-specific incidence rates for IMD tends to be in children aged
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