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An outbreak of meningococcal disease in Gloucestershire
Abstract:
Between October, 1981, and March, 1986, there were 65 cases of meningococcal infection, about five times the expected number, in Gloucester Health District. The cases, mainly in teenagers and young adults, were clustered in the Stroud district and in the southern part of Gloucester City, and most were caused by a sulphonamide-resistant group B type 15 meningococcus. 2 patients died. Only 57% of meningitis cases were formally notified. 7 (11%) patients had septicaemia without meningitis, not a notifiable disease. All meningococcal disease should be made notifiable and meningococci should be serotyped routinely so that the epidemiology of the disease can be monitored before the introduction of suitable vaccines.
Insights
A meningococcal infection outbreak in Gloucester Health District involved a sulphonamide-resistant strain, primarily affecting teenagers and young adults. Enhanced surveillance and routine serotyping are recommended for future vaccine strategies.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- An unusual increase in meningococcal infections was observed in Gloucester Health District between 1981 and 1986.
- The outbreak primarily impacted teenagers and young adults, with cases concentrated in specific areas.
Purpose of the Study:
- To investigate the characteristics of an elevated incidence of meningococcal disease.
- To identify the causative agent and its resistance patterns.
- To assess the notification rates and disease presentation.
Main Methods:
- Retrospective analysis of case data from Gloucester Health District.
- Identification and serotyping of Neisseria meningitidis isolates.
- Review of disease notification records.
Main Results:
- 65 cases of meningococcal infection were recorded, approximately five times the expected number.
- The predominant strain was a sulphonamide-resistant group B type 15 meningococcus.
- Mortality occurred in 2 patients, and 11% presented with septicaemia without meningitis.
- Notification rates for meningitis were suboptimal, with only 57% of cases formally reported.
Conclusions:
- The outbreak highlights the need for improved public health surveillance of meningococcal disease.
- Routine serotyping of meningococci is crucial for epidemiological monitoring.
- Making all forms of meningococcal disease notifiable is recommended.
- These measures are essential for informing the development and deployment of effective vaccines.