EPIDEMIOLOGICAL CHARACTERIZATION OF REPORTED CASES OF MENINGOCOCCAL DISEASE IN THE CITY OF SÃO PAULO, BRAZIL, BETWEEN 2019 AND 2025

Meningitis is a communicable infectious disease with a significant disease burden and possible unfavorable outcomes. In this context, the World Health Organization (WHO) and the Pan American Health Organization (PAHO) developed the roadmap “Defeating Meningitis by 2030: A Global Roadmap”, which sets the following objectives by 2030: eliminate bacterial meningitis epidemics; reduce cases and deaths from vaccine-preventable bacterial meningitis; and reduce sequelae and improve quality of life after meningitis of any etiology. In line with this, the Brazilian Ministry of Health published the “Guidelines for Addressing Meningitis by 2030” in 2024. Furthermore, in 2025, Technical Note No. 77/2025 was released, replacing the booster dose of meningococcal C vaccine with the meningococcal ACWY vaccine. This was a descriptive, quantitative epidemiological study, using secondary data from meningitis epidemiological investigation forms (FIE) in Sinan and the National Immunization Program Information System (SI-PNI), from 2019 to 2025, for reported and confirmed cases of meningococcal disease, as well as data on vaccine coverage. A total of 748 cases were reported and confirmed. The annual incidence per 100,000 inhabitants was approximately 1.65 (2019), 0.63 (2020), 0.40 (2021), 0.84 (2022), 1.22 (2023), and 1.22 (2024). Regarding serogroups, most were group B (38.37%), followed by group C (26.60%), group Y (4.15%), group W (2.67%), and group X (0.8%). As for outcomes, 72.33% were discharged cured and 19.25% died from meningitis. Meningococcal C vaccine coverage in São Paulo was 86.15% in 2019, then 76.25% (2020), 67.23% (2021), 68.11% (2022), 85.5% (2023), and 88.51% (2024). There was a downward trend in disease incidence until 2021, with a subsequent increase through 2023, stabilizing at 1.22 cases per 100,000 inhabitants by 2024. There is still a considerable proportion of serogroup C cases (26.60%), even with increased meningococcal C vaccine coverage. Serogroup B accounts for the largest proportion of reported and confirmed cases (38.37%), and there is no vaccine for this serogroup available in the Brazilian Unified Health System (SUS). Considering the high lethality, it is essential to reinforce training of healthcare professionals for the management of meningococcal disease.