Davison K L, Crowcroft N S, Ramsay M E, Begg N T, Kaczmarski E B, Stuart J M, White J M, Orr H
Immunisation Division, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ.
Commun Dis Public Health. 2002 Sep;5(3):205-12.
Enhanced surveillance of meningococcal disease (ESMD) began in five English regions on 1st January 1998. The aims of the scheme were to obtain accurate incidence data and develop a robust surveillance system with which to monitor the impact of a new meningococcal serogroup C conjugate vaccine. During 1998, 2,314 suspected cases of meningococcal disease were identified. The majority (84%) was classified as invasive meningococcal disease, with infection of N. meningitidis confirmed in 66%. Sixteen per cent of suspected cases were subsequently given an alternative diagnosis. Age differences between those classified as meningococcal disease and those not, implied a higher index of suspicion of meningococcal disease in younger children. Regions with high rates of meningococcal disease were due to a higher rate of serogroup C. ESMD increased ascertainment of meningococcal disease and deaths. Cases were 34% greater than identified through statutory notifications, an additional 6.8% confirmed infections were identified than were reported to the PHLS Meningococcal Reference Unit (MRU) and deaths were 24% greater than death registrations. These data were used to inform the national meningococcal serogroup C conjugate vaccination programme in England and Wales. In 1999 ESMD was extended to all regions of England, Wales and Northern Ireland.
1998年1月1日，英格兰五个地区开始实施脑膜炎球菌病强化监测（ESMD）。该计划的目的是获取准确的发病率数据，并建立一个强大的监测系统，以监测新型C群脑膜炎球菌结合疫苗的影响。1998年期间，共确认了2314例疑似脑膜炎球菌病病例。其中大多数（84%）被归类为侵袭性脑膜炎球菌病，66%的病例确诊为脑膜炎奈瑟菌感染。16%的疑似病例随后被重新诊断。被归类为脑膜炎球菌病的患者与未被归类为该病的患者在年龄上存在差异，这表明年幼儿童患脑膜炎球菌病的疑似指数更高。脑膜炎球菌病发病率较高的地区是由于C群的发病率较高。ESMD提高了脑膜炎球菌病和死亡病例的确诊率。病例数比法定通报所确认的多34%，比向公共卫生实验室服务处脑膜炎球菌参考单位（MRU）报告的病例多确认了6.8%的感染病例，死亡人数比死亡登记数多24%。这些数据被用于为英格兰和威尔士的全国C群脑膜炎球菌结合疫苗接种计划提供参考。1999年，ESMD扩展到英格兰、威尔士和北爱尔兰的所有地区。
