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Influence of age on serogroup distribution of endemic meningococcal disease
Insights
Meningococcal disease serogroup C affects older children compared to serogroup B, which impacts infants. Age distributions varied between endemic and epidemic Neisseria meningitidis infections.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Disseminated meningococcal disease (DMD) poses a significant health risk, particularly in infants and children.
- Understanding the age distribution of Neisseria meningitidis serogroups is crucial for public health interventions.
Purpose of the Study:
- To analyze and compare the age distribution of DMD cases caused by serogroup B and C Neisseria meningitidis in Houston.
- To compare these findings with national data and with serogroup-specific outbreaks in North and South America.
Main Methods:
- Retrospective analysis of 126 hospitalized infants and children with DMD in Houston (1977-1979, 1981).
- Comparison of age distributions between serogroup B and C infections.
- Comparison with US national data and international outbreak data.
Main Results:
- Serogroup B Neisseria meningitidis caused disease in younger children (33% <12 months, 8.6% <3 months) compared to serogroup C (2.7% <3 months, 73% >2 years).
- Serogroup C cases were significantly older than serogroup B cases (P = .017).
- Houston's age distributions mirrored US endemic patterns, but differed from North American group B outbreaks and South American group C epidemics, which affected older populations.
Conclusions:
- Age distribution of Neisseria meningitidis serogroups B and C differs significantly, with serogroup C predominantly affecting older children.
- Endemic and epidemic patterns of meningococcal disease exhibit distinct age demographics.
- Findings highlight the importance of age-specific surveillance and targeted prevention strategies for Neisseria meningitidis.
Abstract:
The age distribution of 126 infants and children with disseminated meningococcal disease hospitalized consecutively in Houston between January 1977 and June 1979, and between January 1981 and June 1981 was analyzed and compared with that in the United States as a whole and to that during outbreaks of group B disease in North America and epidemics of group C disease in South America. Eighty-one (64.3%) isolates from Houston cases were serogroup B and 37 (29.4%) were serogroup C Neisseria meningitidis. Children with serogroup C disease were significantly older than those with group B disease (P = .017). Of the children with serogroup B infections, 33% were less than 12 months of age and 8.6% were less than 3 months of age. Of those with serogroup C disease, only 2.7% were less than 3 months of age and the majority (73%) were more than 2 years of age. These age distributions are similar to those reported for the entire United States during endemic periods. In contrast, focal outbreaks of group B meningococcal infection occurred in populations that were significantly older (0.02 greater than P less than .05). Similarly, epidemic disease in South America due to serogroup C strains also occurred in older children when compared with the occurrence of endemic group C disease in the United States (P = .02).