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Meningococcal disease in the United States--1986. Meningococcal Disease Study Group
R W Pinner1, B G Gellin, W F Bibb
1Division of Bacterial and Mycotic Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
Abstract:
Active surveillance for invasive meningococcal disease was conducted during 1986 and 1987 in six areas of the United States with a total population of approximately 34 million persons. The incidence of meningococcal disease was 1.3:10(5). The highest incidence of disease among the surveillance areas was in Los Angeles County (1.65:10(5). Neisseria meningitidis serogroups B and C caused about equal amounts of disease, which reflects a recent increase in the incidence of group C disease. Group C caused more than half of the cases of meningococcal disease in Los Angeles and Tennessee but less than one-third of the cases in Missouri and Oklahoma. Multilocus enzyme electrophoresis demonstrated that a group of closely related isolates of N. meningitidis was prevalent in Los Angeles during the surveillance period and was associated with an increased incidence of meningococcal disease there.
Insights
Active surveillance identified invasive meningococcal disease incidence at 1.3:10(5). Los Angeles County showed the highest rates, with Neisseria meningitidis serogroups B and C being the primary causes.
Area of Science:
- Epidemiology
- Microbiology
Background:
- Invasive meningococcal disease (IMD) remains a significant public health concern.
- Understanding geographic and serogroup-specific incidence is crucial for targeted interventions.
Purpose of the Study:
- To conduct active surveillance for IMD in the United States.
- To determine the incidence and serogroup distribution of IMD across different regions.
Main Methods:
- Active surveillance was performed in six US areas (approx. 34 million population) during 1986-1987.
- Incidence rates and serogroup prevalence (B and C) were analyzed.
- Multilocus enzyme electrophoresis (MEE) was used to characterize Neisseria meningitidis isolates.
Main Results:
- Overall IMD incidence was 1.3:10(5).
- Los Angeles County exhibited the highest incidence (1.65:10(5).
- Serogroups B and C were equally prevalent, with a notable increase in group C disease. Group C predominated in Los Angeles and Tennessee, while less common in Missouri and Oklahoma. MEE identified a prevalent, closely related N. meningitidis strain in Los Angeles associated with elevated disease incidence.
Conclusions:
- Neisseria meningitidis serogroups B and C are key drivers of invasive meningococcal disease.
- Geographic variations in serogroup prevalence exist, with implications for public health strategies.
- Specific N. meningitidis strains may contribute to localized outbreaks of invasive meningococcal disease.