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Meningococcal Reference Unit: surveillance and research

The Meningococcal Reference Unit (MRU) has been a world leader in developing tests for non-culture case confirmation of meningococcal infection by PCR (polymerase chain reaction), and making the tests available nationally.

The range of tests, which were initially designed to identify the major disease-causing serogroups, has recently been extended to provide more detailed additional characterisation, using state-of-the-art molecular techniques such as DNA sequencing of genomic material from isolates and directly from clinical specimens.

The MRU also played a big role in the introduction of the meningococcal C conjugate vaccine (MCC) in 1999. The vaccine is seen as one of the most important public health developments in recent years, and more than a quarter of the UK's population have now received it.


Surveillance of the effect of the MCC vaccine has helped assess how efficient its introduction has been and to demonstrate evidence of herd immunity.

The MRU has been monitoring clinical isolates for evidence of 'immunological pressure' as a result of vaccination, such as capsule 'switching', and has shown that this has not occurred in England and Wales.

This level of surveillance, along with serological studies performed in the Health Protection Agency's Vaccine Evaluation Department (VEU), has been the key to supporting and monitoring the MCC vaccine in the UK, and establishing the international reputation of the MRU.

The MRU works closely with the VEU (both are based in the Manchester Microbiology Partnership at Manchester Royal Infirmary) to support research and development of meningococcal vaccines.

Current MRU-VEU activities support the novel protein-based, broad spectrum meningococcal vaccines designed to combat serogroup B meningococci, which is the predominant cause of meningococcal infection in the UK.

The benefits of the MRU's enhanced surveillance were clear when the UK became the first country to recognise the importation and spread of a strain of serogroup W135 meningococci following the Hajj pilgrimage of 2000.