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
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.