Invasive Meningococcal Disease

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Nationally notifiable since 1924

1.0 National Notification

Both confirmed and probable cases of disease should be notified as of January 1, 2006.

2.0 Type of Surveillance

Routine case-by-case notification to the federal level

Enhanced case-by-case notification to the Centre for Immunization and Respiratory Infectious Diseases

Enhanced case-by-case notification to International Circumpolar Surveillance in participating Northern regions

3.0 Case Classification

3.1 Confirmed case

Clinical evidence of invasive disease (see section 5.0) with laboratory confirmation of infection:

• isolation of Neisseria meningitidis from a normally sterile site (blood, CSF, joint, pleural or pericardial fluid)
  OR
• demonstration of N. meningitidis DNA by an appropriately validated nucleic acid test (NAT) from a normally sterile site

3.2 Probable case

Clinical evidence of invasive disease with purpura fulminans or petechiae, with no other apparent cause and with non-confirmatory laboratory evidence:

• detection of N. meningitidis antigen in the CSF

4.0 Laboratory Comments

Positive antigen test results from urine and serum samples are unreliable for diagnosing meningococcal disease.

5.0 Clinical Evidence

Clinical illness associated with invasive meningococcal disease usually manifests itself as meningitis and/or septicaemia, although other manifestations may be observed (e.g. orbital cellulitis, septic arthritis). Invasive disease may progress rapidly to petechiae or purpura fulminans, shock and death.

6.0 ICD Code(s)

6.1 ICD-10 Code(s)

A39

Meningococcal infection

6.2 ICD-9/ICD-9CM Code(s)

036

Meningococcal infection

7.0 Type of International Reporting

Notification in the event of a public health emergency is required under the International Health Regulations (2005).

8.0 Comments

Each jurisdiction will have an existing validation process for the NAT.

The case definitions for invasive meningococcal disease provided in this document are for routine and enhanced surveillance purposes. Definitions of cases (sporadic, index, subsequent), close contacts, and organization-based and communitybased outbreaks for the purposes of public health management are provided in the national Guidelines for the Prevention and Control of Meningococcal Disease (http://www.phac-aspc.gc.ca/publicat/ccdrrmtc/05vol31/31s1/index.html).

9.0 References

Public Health Agency of Canada. Guidelines for the prevention and control of meningococcal disease. CCDR 2005;31S1:1-20.

10.0 Previous Case Definitions

Canadian Communicable Disease Surveillance System: disease-specific case definitions and surveillance methods. Can Dis Wkly Rep 1991;17S3.

Case definitions for diseases under national surveillance. CCDR 2000;26(S3).

Date of Last Revision/Review:

May 2008