Genomic epidemiology of invasive meningococcal disease in Scotland before, during, and after the COVID-19 pandemic: a retrospective observational study.

Publication date: Jul 21, 2026

Invasive meningococcal disease (IMD) remains a major global health threat. Despite vaccination, meningococcal genetic diversity means disease, including epidemics at various scales, still occurs unpredictably, highlighting the need for real-time genomic surveillance. The COVID-19 pandemic reduced invasive respiratory diseases, but its effect on IMD distribution remains unassessed. We aimed to investigate the effect of the COVID-19 pandemic and consequent social restrictions on genomic and demographic characteristics of IMD in Scotland to inform public health policy. In this retrospective, observational analysis, we used genomic and epidemiological surveillance data of cases of IMD reported in Scotland between July 1, 2009, and April 20, 2026. Genomic data (from whole genome characterisation of culture-confirmed IMD cases) were obtained from the public databases for molecular typing and microbial genome diversity (PubMLST) and demographic data were obtained from the Meningococcal Invasive Disease Augmented Surveillance database. The pre-COVID-19 period was defined as July 1, 2009, to March 23, 2020, the COVID-19 period was March 24, 2020, to March 18, 2022, and the post-COVID-19 period was March 19, 2022, to April 20, 2026. A total of 27 binary outcomes derived from the genomic and demographic variables were prespecified before model fitting. We assessed associations with interrupted time-series analyses to establish changes related to the COVID-19 pandemic. Between July 1, 2009, and April 20, 2026, 1143 IMD cases were reported in Scotland. Of these, 512 (44.8%) were culture-confirmed cases with a corresponding meningococcal genome. High-risk groups (including children aged

Open Access PDF

Semantics

Original Article