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. 2025 Apr 25;7(17):568-573.
doi: 10.46234/ccdcw2025.095.

Epidemiological and Clinical Features of Meningococcal Meningitis in Infants - China, 2006-2023

Qian Zhang  1 , Jiajia Zhou  1 , Mingshuang Li  1 , Tingting Yan  1 , Dan Wu  1 , Zhijie An  1 , Zundong Yin  1 , Hui Zheng  1
Affiliations

Epidemiological and Clinical Features of Meningococcal Meningitis in Infants - China, 2006-2023

Qian Zhang et al. China CDC Wkly. .

Abstract

Introduction: Infants have the highest incidence of meningococcal meningitis (MM) among all age groups in China. Infants receive their first and second doses of serogroup A meningococcal polysaccharide vaccine at 6 and 9 months of age.

Methods: We extracted data on MM cases among 0-11-month-old children reported during 2006-2023 from the National Notifiable Diseases Registry System and the National Meningococcal Disease Surveillance System and conducted an epidemiological and clinical analysis.

Results: During the study period, 721 infant MM cases were reported. Incidence decreased from 7.31 cases per million to 2.74 per million, while the all-age incidence declined from 1.27 cases per million to 0.06 per million. Among 210 cases with serogrouping results, five serogroups (A, B, C, W, Y) and non-groupable strains were detected. Serogroup A cases decreased from 36.36% to 1.87% during the study period, while serogroup B increased from 14.55% to 67.29%. Fever, nausea, and/or vomiting were common symptoms across all serogroups. The frequencies of petechiae and/or purpura in serogroup A (73%) and C (92%) were substantially higher than in other serogroups. Among serogroup B cases, 26.42% developed petechiae and/or purpura, 26.42% exhibited neck stiffness, and 13.21% had positive Kernig's and/or Brudzinski's signs.

Conclusions: The incidence of MM in infants has significantly decreased but remains higher than incidence across all age groups. Serogroup B cases were the most common. Atypical symptoms in infant cases challenge timely diagnosis. We suggest eligible infants receive meningococcal vaccination timely, and the development of serogroup B meningococcal vaccines should be accelerated.

Keywords: Infants; Meningococcal meningitis; Serogroups.

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Conflict of interest statement

No conflicts of interest.

Figures

Figure 1
Figure 1
Incidence and case-fatality rates of reported MM in all ages and in infants in China, 2006–2023. Abbreviation: MM=meningococcal meningitis.
Figure 2
Figure 2
Serogroup distribution of 210 Neisseria meningitidis cases by age group during the entire study period of (A) 2006–2023; (B) 2006–2010; (C) 2011–2015; and (D) 2016–2023.
See this image and copyright information in PMC

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