Invasive meningococcal disease over five decades in the Faroe Islands: high incidence, low mortality, and implications for vaccination policy

Background The Faroe Islands have previously experienced a very high incidence of meningococcal disease, with an epidemic beginning in the late 1970s followed by more than a decade of endemic transmission. Aim To present a population-based epidemiological overview of invasive meningococcal disease (IMD) in the Faroe Islands from 1980 to 2025. Methods Cases were identified through records from the Chief Medical Officer and hospital diagnosis registers. Clinical data were extracted from hospital records. Results A total of 234 IMD cases were identified. Incidence peaked in 1981 at 100 per 100,000 population and declined gradually to 13 per 100,000 by 1990, remaining stable at 0–7 per 100,000 thereafter. 91% of cases occurred in individuals under 20 years of age, with 53%in children aged ≤4 years. The case fatality rate was 5% in 1980-1986 and zero thereafter. The predominant serogroup was B, with a prevalence of 89% until 1984 followed by a decline to 77% in the following years (1985-2025). Conclusion IMD in the Faroe Islands was characterized by an unusually high and prolonged incidence followed by a marked decline to low endemic levels, with consistently low mortality. Despite the current low incidence, the potential role of childhood meningococcal vaccination warrants further evaluation.