The Global Meningococcal Initiative (GMI) aims to prevent invasive meningococcal disease (IMD) worldwide through education, research and cooperation. In March 2019, a GMI meeting was held with a multidisciplinary group of experts and representatives from countries within Eastern Europe. Across the countries represented, IMD surveillance is largely in place, with incidence declining in recent decades and now generally at <1 case per 100,000 persons per year. Predominating serogroups are B and C, followed by A, and cases attributable to serogroups W, X and Y are emerging. Available vaccines differ between countries, are generally not included in immunization programs and provided to high-risk groups only. Available vaccines include both conjugate and polysaccharide vaccines; however, current data and GMI recommendations advocate the use of conjugate vaccines, where possible, due to the ability to interrupt the acquisition of carriage. Ongoing carriage studies are expected to inform vaccine effectiveness and immunization schedules. Additionally, IMD prevention and control should be guided by monitoring outbreak progression and the emergence and international spread of strains and antibiotic resistance through use of genomic analyses and implementation of World Health Organization initiatives. Protection of high-risk groups (such as those with complement deficiencies, laboratory workers, migrants and refugees) is recommended.

Baku Medical Plaza Baku Azerbaijan

Cantacuzino National Medico Military Institute for Research Development Bucharest Romania

Central Research Institute of Epidemiology Moscow Russia

Eskisehir Osmangazi University Eskisehir Turkey

Institute for Public Health Sombor Serbia

Institute of Health Carlos 3 Madrid Spain

Kazakh National Medical University Almaty Kazakhstan

Meningitis Research Foundation Bristol UK

Meningococcal Reference Unit Public Health England Manchester Royal Infirmary Manchester M13 9WZ UK

National Center for Disease Control and Public Health Tbilisi Georgia

National Institute of Public Health Prague Czechia

National Public Health Center Budapest Hungary

National Reference Centre for Bacterial Meningitis National Medicines Institute Warsaw Poland

National Reference Centre for Meningococci Institute Pasteur Paris France

Norwegian Institute of Public Health Oslo Norway

Republican Research and Practical Center for Epidemiology and Microbiology Minsk Belarus

Riga East University Hospital Riga Latvia

Scientific and Production Association Preventive Medicine Bishkek Kyrgyzstan

The Centre for Disease Prevention and Control of Latvia Riga Latvia

University Hospital for Infectious Diseases Zagreb Croatia

References provided by Crossref.org

Invasive meningococcal disease in South-Eastern European countries: Do we need to revise vaccination strategies?