Meningococcal meningitis increase in Moscow associated with
serogroup A: advice to travellers
There has been a rise in the number of cases of meningococcal
meningitis in Moscow. By the end of October 2003, there had been 268 cases
(including 22 deaths) mostly in children, which is approximately twice the
average number of cases reported (1). Unusually, many of the cases have been
reported at the end of the summer and in early autumn; the usual seasonal
increase is in February and March. Meningococcal serogroup A has been identified
in 90% of the strains isolated. The city health authorities in Moscow have
initiated a mass vaccination campaign in order to prevent further cases occurring
during the coming peak transmission season.
Cases of meningococcal serogroup A infection are rare in the European Union,
and it is uncommon to even have infections associated with travel to those
endemic areas where serogroup A is most frequent, such as the meningitis
belt in Africa, and therefore it is not anticipated that many cases will
be imported from Russia into the EU.
The National Travel Health Network and Centre in England (NaTHNaC, http://www.nathnac.org)
has issued guidance for English health professionals who may be advising
travellers to Moscow (2), recommending that meningococcal vaccine should
only be considered for travellers to Moscow who will be teaching in schools,
attending university or other courses, frequenting crowded bars and clubs
or working in a medical setting.
The European Union Invasive Bacterial Infections Surveillance Network (EU-IBIS,
would be interested to know what guidance is being issued in other European
countries; please email information to Sarah Handford (email@example.com).