{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:43:27Z","timestamp":1780544607102,"version":"3.54.1"},"reference-count":46,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T00:00:00Z","timestamp":1693440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Invasive meningococcal disease (IMD) is a devastating disease with significant mortality and long-term morbidity. The COVID-19 pandemic and containment measures have affected the epidemiology of infectious pathogens. This study\u2019s aim was to assess IMD trends in Israel prior to and during the COVID-19 pandemic. The Neisseria meningitidis invasive infection is a notifiable disease in Israel. Laboratory analysis includes serogrouping and molecular characterization. The overall national IMD incidence rate (1998\u20132022) was 0.8\/100,000 population. The IMD incidence rates declined during the pandemic years (0.3\/100,000 in 2020\u20132022 vs. 0.9\/100,000 in 1998\u20132019). The number of notified IMD cases declined by 65% in 2020\u20132022. The case fatality rate among laboratory-confirmed IMD cases was 9% (47\/521, 2007\u20132022). Mortality risk markers included cases\u2019 age (older) and socio-economic status (lower). Overall, most Neisseria meningitidis isolates were of serogroup B (62.6%), and the most prevalent clonal complex (CC) was CC32 (24.2%). Serogroup B prevailed in cases aged 0\u20139 years (74.5%) and less in cases aged 10 years and above (39%). Neisseria meningitidis serogroups and CC distribution altered recently with a decline in serogroup B fraction, an increase in serogroup Y, and a decline in CC32. Ongoing IMD surveillance is necessary to assess trends in circulating strains and support decision-making on meningococcal vaccination programs.<\/jats:p>","DOI":"10.3390\/microorganisms11092212","type":"journal-article","created":{"date-parts":[[2023,8,31]],"date-time":"2023-08-31T11:33:25Z","timestamp":1693481605000},"page":"2212","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Invasive Disease Due to Neisseria meningitidis: Surveillance and Trends in Israel Prior to and during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8847-7510","authenticated-orcid":false,"given":"Chen","family":"Stein-Zamir","sequence":"first","affiliation":[{"name":"Jerusalem District Health Office, Ministry of Health, 86 Jaffa Road, Jerusalem 9434124, Israel"},{"name":"Faculty of Medicine, Hadassah Braun School of Public Health, The Hebrew University of Jerusalem, Jerusalem 9112102, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Shoob","sequence":"additional","affiliation":[{"name":"Jerusalem District Health Office, Ministry of Health, 86 Jaffa Road, Jerusalem 9434124, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitza","family":"Abramson","sequence":"additional","affiliation":[{"name":"Jerusalem District Health Office, Ministry of Health, 86 Jaffa Road, Jerusalem 9434124, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Valinsky","sequence":"additional","affiliation":[{"name":"Public Health Laboratories Jerusalem, Public Health Services, Ministry of Health, Jerusalem 9546208, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Public Health Laboratories Jerusalem, Public Health Services, Ministry of Health, Jerusalem 9546208, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Maimoun","sequence":"additional","affiliation":[{"name":"Public Health Laboratories Jerusalem, Public Health Services, Ministry of Health, Jerusalem 9546208, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Amit","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, Sheba Medical Center, Ramat Gan 5266202, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Davidovich-Cohen","sequence":"additional","affiliation":[{"name":"Public Health Laboratories Jerusalem, Public Health Services, Ministry of Health, Jerusalem 9546208, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.idc.2019.08.007","article-title":"Invasive Pneumococcal and Meningococcal Disease","volume":"33","author":"Fitzgerald","year":"2019","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/j.jinf.2020.05.079","article-title":"The everchanging epidemiology of meningococcal disease worldwide and the potential for prevention through vaccination","volume":"81","author":"Parikh","year":"2020","journal-title":"J. Infect."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2768","DOI":"10.1016\/j.vaccine.2019.04.020","article-title":"Case fatality rates of invasive meningococcal disease by serogroup and age: A systematic review and meta-analysis","volume":"37","author":"Wang","year":"2019","journal-title":"Vaccine"},{"key":"ref_4","unstructured":"World Health Organization (2023, July 07). Defeating Meningitis by 2030. Available online: https:\/\/www.who.int\/initiatives\/defeating-meningitis-by-2030."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.ijid.2021.04.070","article-title":"World Meningitis Day and the World Health Organization\u2019s roadmap to defeat bacterial meningitis in the COVID-19 pandemic era","volume":"107","author":"Pinto","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1007\/s15010-013-0439-6","article-title":"Dynamics of childhood invasive meningococcal disease in Israel during a 22-year period (1989\u20132010)","volume":"41","author":"Dagan","year":"2013","journal-title":"Infection"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6186","DOI":"10.1016\/j.vaccine.2019.08.055","article-title":"Surveillance of invasive meningococcal disease in the Tel Aviv District, Israel, 2007\u20132017","volume":"37","author":"Salama","year":"2019","journal-title":"Vaccine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1080\/21645515.2018.1507261","article-title":"Invasive meningococcal disease epidemiology and characterization of Neisseria meningitidis serogroups, sequence types, and clones; implication for use of meningococcal vaccines","volume":"15","author":"Shoob","year":"2019","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_9","unstructured":"Ministry of Health, Israel (2023, July 07). Immunization Guidelines, Available online: https:\/\/www.health.gov.il\/English\/Topics\/Vaccination\/Pages\/default.aspx."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e360","DOI":"10.1016\/S2589-7500(21)00077-7","article-title":"Changes in the incidence of invasive disease due to Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitidis during the COVID-19 pandemic in 26 countries and territories in the Invasive Respiratory Infection Surveillance Initiative: A prospective analysis of surveillance data","volume":"3","author":"Brueggemann","year":"2021","journal-title":"Lancet Digit. Health"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"972","DOI":"10.3390\/microorganisms10050972","article-title":"Pathogen- and Type-Specific Changes in Invasive Bacterial Disease Epidemiology during the First Year of the COVID-19 Pandemic in The Netherlands","volume":"10","author":"Steens","year":"2022","journal-title":"Microorganisms"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"907","DOI":"10.3390\/microorganisms10050907","article-title":"Changes in Invasive Neisseria meningitidis and Haemophilus influenzae Infections in France during the COVID-19 Pandemic","volume":"10","author":"Deghmane","year":"2022","journal-title":"Microorganisms"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"849","DOI":"10.3390\/jcm12030849","article-title":"Epidemiology and Clinical Burden of Meningococcal Disease in France: Scoping Review","volume":"12","author":"Baloche","year":"2023","journal-title":"J. Clin. Med."},{"key":"ref_14","unstructured":"Israel Central Bureau of Statistics (2023, July 07). Characterization and Classification of Geographical Units by the Socio-Economic Level of the Population, Available online: https:\/\/www.cbs.gov.il\/en\/mediarelease\/Pages\/2018\/Characterization-and-Classification-of-Geographical-Units-by-the-Socio-Economic-Level-of-the-Population-2015.aspx."},{"key":"ref_15","unstructured":"(2023, July 07). Ministry of Health Israel, Weekly Epidemiological Reports, Available online: https:\/\/www.gov.il\/he\/Departments\/DynamicCollectors\/weekly-epidemiological-report?skip=0."},{"key":"ref_16","unstructured":"The Central Bureau of Statistics (CBS), Israel (2023, July 07). Statistical Abstract of Israel, Available online: https:\/\/www.cbs.gov.il\/en\/Pages\/search\/yearly.aspx."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"124","DOI":"10.12688\/wellcomeopenres.14826.1","article-title":"Open-access bacterial population genomics: BIGSdb software, the PubMLST.org website and their applications","volume":"3","author":"Jolley","year":"2018","journal-title":"Wellcome Open Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2002075","DOI":"10.2807\/1560-7917.ES.2022.27.3.2002075","article-title":"Evolution of invasive meningococcal disease epidemiology in Europe, 2008 to 2017","volume":"27","author":"Nuttens","year":"2022","journal-title":"Euro Surveill."},{"key":"ref_19","unstructured":"Centers for Disease Control and Prevention (2023, July 07). Meningococcal Disease Surveillance, Available online: https:\/\/www.cdc.gov\/meningococcal\/surveillance\/."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Guedes, S., Bricout, H., Langevin, E., Tong, S., and Bertrand-Gerentes, I. (2022). Epidemiology of invasive meningococcal disease and sequelae in the United Kingdom during the period 2008 to 2017\u2014A secondary database analysis. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-12933-3"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1080\/14760584.2023.2225596","article-title":"Invasive Meningococcal Disease epidemiology and vaccination strategies in four Southern European countries: A review of the available data","volume":"22","author":"Zografaki","year":"2023","journal-title":"Expert. Rev. Vaccines"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.1016\/j.vaccine.2017.03.007","article-title":"The epidemiology of invasive meningococcal disease in EU\/EEA countries, 2004\u20132014","volume":"35","author":"Whittaker","year":"2017","journal-title":"Vaccine"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1017\/S0950268807009259","article-title":"Invasive meningococcal disease in children in Jerusalem","volume":"136","author":"Abramson","year":"2008","journal-title":"Epidemiol. Infect."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1097\/INF.0000000000000282","article-title":"The clinical features and long-term sequelae of invasive meningococcal disease in children","volume":"33","author":"Shoob","year":"2014","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_25","unstructured":"GBD 2016 Meningitis Collaborators (2018). Global, regional, and national burden of meningitis, 1990\u20132016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol., 17, 1061\u20131082."},{"key":"ref_26","unstructured":"GBD 2019 Antimicrobial Resistance Collaborators (2022). Global mortality associated with 33 bacterial pathogens in 2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet, 400, 2221\u20132248."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wright, C., Blake, N., Glennie, L., Smith, V., Bender, R., Kyu, H., Wunrow, H.Y., Liu, L., Yeung, D., and Knoll, M.D. (2021). The Global Burden of Meningitis in Children: Challenges with Interpreting Global Health Estimates. Microorganisms, 9.","DOI":"10.3390\/microorganisms9020377"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e246","DOI":"10.1017\/S0950268820002356","article-title":"A meta-analytic evaluation of sex differences in meningococcal disease incidence rates in 10 countries","volume":"148","author":"Green","year":"2020","journal-title":"Epidemiol. Infect."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.yapd.2020.03.007","article-title":"Meningococcal Infections in Children and Adolescents: Update and Prevention","volume":"67","author":"Brady","year":"2020","journal-title":"Adv. Pediatr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"519","DOI":"10.3390\/microorganisms9030519","article-title":"A Narrative Review of the W, X, Y, E, and NG of Meningococcal Disease: Emerging Capsular Groups, Pathotypes, and Global Control","volume":"9","author":"Tzeng","year":"2021","journal-title":"Microorganisms"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"ofac482","DOI":"10.1093\/ofid\/ofac482","article-title":"Prevalence and Characteristics of Carriage of Neisseria meningitidis Among Young Israeli Adults","volume":"9","author":"Motro","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/14760584.2019.1557520","article-title":"The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations","volume":"18","author":"Acevedo","year":"2019","journal-title":"Expert. Rev. Vaccines"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.jinf.2021.11.016","article-title":"Surveillance and control of meningococcal disease in the COVID-19 era: A Global Meningococcal Initiative review","volume":"84","author":"Alderson","year":"2022","journal-title":"J. Infect."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1521","DOI":"10.3390\/microorganisms8101521","article-title":"Vaccines against Meningococcal Diseases","volume":"8","author":"Pizza","year":"2020","journal-title":"Microorganisms"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1080\/21645515.2018.1458175","article-title":"Global epidemiology of serogroup B meningococcal disease and opportunities for prevention with novel recombinant protein vaccines","volume":"14","author":"Villena","year":"2018","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1186\/s12955-019-1159-0","article-title":"DELPHI study on aspects of study design to overcome knowledge gaps on the burden of disease caused by serogroup B invasive meningococcal disease","volume":"17","author":"Marten","year":"2019","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"887677","DOI":"10.3389\/fneur.2022.887677","article-title":"Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study","volume":"13","author":"Gofrit","year":"2022","journal-title":"Front. Neurol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ajic.2009.04.290","article-title":"Preventive effect of meningococcal vaccination in Israeli military recruits","volume":"38","author":"Mimouni","year":"2010","journal-title":"Am. J. Infect. Control."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1186\/s13584-021-00442-4","article-title":"The National Immunization Technical Advisory Group in Israel","volume":"10","author":"Rishpon","year":"2021","journal-title":"Isr. J. Health Policy Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s00038-016-0821-0","article-title":"Cost-utility analysis of a nationwide vaccination programme against serogroup B meningococcal disease in Israel","volume":"61","author":"Ginsberg","year":"2016","journal-title":"Int. J. Public. Health"},{"key":"ref_41","unstructured":"Ministry of Health, Israel (2023, July 07). The Expansion of the Health Services Basket for 2023, Available online: https:\/\/www.gov.il\/he\/departments\/publications\/reports\/hbs2023."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1056\/NEJMoa1901229","article-title":"Vaccination of Infants with Meningococcal Group B Vaccine (4CMenB) in England","volume":"382","author":"Ladhani","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1056\/NEJMoa2206433","article-title":"Effectiveness of a Meningococcal Group B Vaccine (4CMenB) in Children","volume":"388","author":"Castilla","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Di Pietro, G.M., Biffi, G., Castellazzi, M.L., Tagliabue, C., Pinzani, R., Bosis, S., and Marchisio, P.G. (2022). Meningococcal Disease in Pediatric Age: A Focus on Epidemiology and Prevention. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph19074035"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1016\/j.jinf.2022.09.001","article-title":"Public health perspective of a pentavalent meningococcal vaccine combining antigens of MenACWY-CRM and 4CMenB","volume":"85","author":"Fragapane","year":"2022","journal-title":"J. Infect."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2186111","DOI":"10.1080\/21645515.2023.2186111","article-title":"Changing patterns of invasive meningococcal disease and future immunization strategies","volume":"19","author":"Taha","year":"2023","journal-title":"Hum. Vaccine Immunother."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/11\/9\/2212\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:44:06Z","timestamp":1760129046000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/11\/9\/2212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,31]]},"references-count":46,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["microorganisms11092212"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms11092212","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,31]]}}}