National case definition: Invasive Meningococcal Disease
Invasive meningococcal disease
Date of last revision/review: May 2008
Both confirmed and probable cases of disease should be notified as of January 1, 2006.
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
Clinical evidence of invasive disease (see Clinical evidence section) with laboratory confirmation of infection:
- isolation of Neisseria meningitidis from a normally sterile site (blood, CSF, joint, pleural or pericardial fluid)
- demonstration of N. meningitidis DNA by an appropriately validated nucleic acid test (NAT) from a normally sterile site
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
Positive antigen test results from urine and serum samples are unreliable for diagnosing meningococcal disease.
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 topetechiae or purpura fulminans, shock and death.
- ICD-10 code(s)
- A39 Meningococcal infection
- ICD-9/ICD-9CM code(s)
- 036 Meningococcal infection
Type of international reporting
Under Article 6 of the International Health Regulations (IHR) (2005), each State Party shall notify the World Health Organization (WHO) by way of the IHR National Focal Point, and within 24 hours of assessment of public health information, of all events which may constitute a public health emergency of international concern within its territory in accordance with the decision instrument (Annex 2 of the IHR), as well as any health measure implemented in response to those events.
- An event involving diseases that are of special national or regional concern, e.g. meningococcal disease, shall always lead to the utilization of the algorithm in Annex 2 of the IHR, because they have demonstrated the ability to cause serious public health impact and to spread rapidly internationally. The need to notify such events to the WHO will depend upon the outcome of the assessment using the Annex 2 decision instrument.
Note: If event does not meet the criteria for notification under Article 6 of the IHR, then other IHR-related reporting requirements may still apply with WHO and/or other States Parties, including those under Art. 7 (information-sharing during unexpected or unusual public health events), Art. 8 (consultation with WHO on public health events), Art. 9 (any public health risk that may cause international disease spread), Art. 10 (requests for verification from WHO), and Art. 44 (collaboration and assistance).
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 community-based 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/ccdr-rmtc/05vol31/31s1/index.html).
Public Health Agency of Canada. Guidelines for the prevention and control of meningococcal disease. CCDR 2005;31S1:1-20.
World Health Organization. International Health Regulations (2005). 3rd ed. Geneva, 2016, from http://www.who.int/ihr/publications/9789241580496/en/
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).
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