ArticleTropical medicine and health2026
Nationwide epidemiology of invasive meningococcal disease in Japan, 2017-2025: implications of post-COVID-19 mobility.
Article in Tropical medicine and health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
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10 authors.
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Abstract
backgroundInvasive meningococcal disease (IMD) is a severe but rare infection in Japan. Changes in population mobility before, during, and after the Coronavirus disease 2019 (COVID-19) pandemic may have influenced IMD trends; however, recent epidemiological patterns in Japan remain incompletely described.
methodsNational surveillance data from January 2017 to October 2025 were analyzed. Temporal, age-specific, and geographic patterns were evaluated across three phases: Phase 1 (2017-2019, pre-COVID-19), Phase 2 (2020-2022, pandemic period), and Phase 3 (2023-October 2025, post-pandemic period with relaxed preventive measures). The relationship between annual IMD case counts and inbound international travel was explored using Spearman's rank correlation.
resultsA total of 288 IMD cases were identified. Annual case numbers decreased markedly from 48 in 2019 to 1 in 2021 and subsequently increased to 66 in 2024 and 68 by October 2025. Case counts were significantly lower in Phase 2 than in Phase 1 (p = 0.0003) and significantly higher in Phase 3 than in Phase 2 (p < 0.0001). Older adults consistently accounted for the largest number of cases, and adolescents showed a clear rebound in Phase 3. Geographic patterns demonstrated substantial prefectural heterogeneity; Tokyo showed the largest proportional increase, whereas Osaka and the Kansai region did not show a corresponding increase. Importantly, no distinct short-term increase in IMD incidence was observed during the Osaka Expo 2025 period. IMD case counts and inbound international travel exhibited parallel temporal patterns over the study period (Spearman's ρ = 1.000).
conclusionsIMD incidence in Japan decreased during the COVID-19 pandemic and increased again following the relaxation of public health measures. The post-pandemic rebound occurred alongside recovery of social contact and population mobility, while most cases were domestically acquired, and no event-specific surge was detected during the Osaka Expo 2025 period. These findings suggest that multiple contextual factors, including societal reopening and travel-related dynamics, may have contributed to the observed trends; however, causal relationships cannot be determined from this ecological analysis.
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