MenW now appears to be endemic in England, with cases now in young children, and across all regions.  Previously used to only be seen in epidemics, particularly related to Haj travel.

Numbers now about 1/4 those of MenB.

Mortality rate approx 12%.  Some adult cases of septicaemia progressing rapidly to death.  Some atypical presentations eg arthritis, severe pneumonia, GI symptoms without non-blanching rash (still rapidly progessive).

JCVI have recommended vaccinating all UK adolescents aged 14-18 years of age (school years S3-S6 in Scotland) with MenACWY as soon as practicable, this is in addition to introduction of Bexsero® vaccine (MenB) for all infants in Scotland.