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The changing epidemiology of meningococcal disease in the United States, 1992-1996.

Research paper by N E NE Rosenstein, B A BA Perkins, D S DS Stephens, L L Lefkowitz, M L ML Cartter, R R Danila, P P Cieslak, K A KA Shutt, T T Popovic, A A Schuchat, L H LH Harrison, A L AL Reingold

Indexed on: 24 Nov '99Published on: 24 Nov '99Published in: The Journal of infectious diseases



Abstract

New meningococcal vaccines are undergoing clinical trials, and changes in the epidemiologic features of meningococcal disease will affect their use. Active laboratory-based, population-based US surveillance for meningococcal disease during 1992-1996 was used to project that 2400 cases of meningococcal disease occurred annually. Incidence was highest in infants; however, 32% of cases occurred in persons >/=30 years of age. Serogroup C caused 35% of cases; serogroup B, 32%; and serogroup Y, 26%. Increasing age (relative risk [RR], 1.01 per year), having an isolate obtained from blood (RR, 4.5), and serogroup C (RR, 1.6) were associated with increased case fatality. Among serogroup B isolates, the most commonly expressed serosubtype was P1.15; 68% of isolates expressed 1 of the 6 most common serosubtypes. Compared with cases occurring in previous years, recent cases are more likely to be caused by serogroup Y and to occur among older age groups. Ongoing surveillance is necessary to determine the stability of serogroup and serosubtype distribution.