Table 4.

Characteristics of meningococcal outbreaks/epidemics in the Asia–Pacific 1997–2020

Region, setting	Outbreak years	Serogroup	Age group primarily affected	No. of cases	Attack rate per 100,000	CFR (%)	Vaccine intervention and outcome	Ref
Australia
Victoria Secondary school	1999	C	Year 9 and 10 students	3	187	0	MenC-PS for students, staff, family contacts No further cases	[79]
New South Wales Secondary school	2003	C	High school children	3	–	0	MenC-CV for students No further cases. Accelerated introduction of the National MenC Programme for years 10, 11 and 12 at the school and expanded to years 7, 8 and 9	[78]
Sydney	2008	B	2–13 y	3	10.7	0	No vaccine available	[133]
Central Australia Indigenous communities	2017	W	≤ 4 y	24	10.9	0	MenACWY-CV for 1–19 y (indigenous then also non-indigenous). 6 additional cases, all unimmunised	[80]
Tasmania	2018	W	–	3	–	–	State-wide campaign with MenACWY-CV expanded to 6 w–21 y	[134]
New Zealand
New Zealand	1991–1996	B	< 5 y	473 in 1996	14.0 (142 in < 1 y, 549.6 in Maori < 1 y)	~ 5	Development of MeNZB (Chiron) with implementation from 2004	[60, 135]
Northland	2011	C	–	–	–	–	MenC-CV for 1 to < 20 y 1 case in unvaccinated infant	[14]
Northland	2018–2019	W	Children, adolescents	7	8.1 (22.7 for Maori)	43	MenACWY-CV for 9 m–4 y and 13–19 y	[21]
India
New Delhi	2005–2006	A	78% in 6–29 y	55	–	15	No vaccine intervention	[136]
Soldiers deployed in operations	2006	A	21–26 y	17	–	12	No vaccine intervention Outbreak contained using chemoprophylaxis	[137]
Delhi community outbreak	2008	A	–	73	–	–	–	[138]
China
Anhui province 8 middle schools, cooking school, police school	2003–2005	C	Middle school attendees	72	–	7	MenAC-PS for school students and children < 6 y	[26]

CV conjugate vaccine, CFR case fatality rate, m months of age, MeNZB meningococcal serogroup B outer membrane protein vaccine, Men(A/C/W/Y) meningococcal vaccine containing one serogroup or combinations of serogroups A, C, W and Y, PS polysaccharide vaccine, Ref source reference, y years of age