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Meningococcal disease epidemiology and control in New Zealand
Abstract:
Epidemiology, surveillance and research New Zealand has a high quality surveillance system for meningococcal disease that successfully integrates notification and laboratory data. Since 1991, New Zealand has had elevated incidence rates of meningococcal disease rising to 6.2 per 100,000 population in 1994. This represents a rate that is four times that recorded in 1989/90. Serogroup B infection predominates and international experience suggests that these elevated rates may continue for 5 to 15 years. Rates of meningococcal disease in Maori and Pacific Islands populations were three times higher than in Europeans at 10.0 and 12.3 per 100,000 respectively in 1994. The rates were particularly high for infants with the rate in Maori infants under 1 year reaching 120 per 100,000. The case fatality rate at 5.3% for 1994 would appear to be relatively low by international standards. Case control studies could be used to investigate potentially modifiable primary risk factors for disease. Intensive case review studies to investigate the role of such factors as preadmission antibiotics in reducing severe outcomes may be of benefit. The Ministry of Health or research funding organisations should consider the potential value of such studies in more detail.
Insights
New Zealand experienced a significant rise in meningococcal disease, particularly among Maori and Pacific Islander infants. Further research into risk factors and interventions is recommended to address this public health concern.
Area of Science:
- Epidemiology
- Public Health Surveillance
- Infectious Disease Research
Background:
- New Zealand has a robust surveillance system integrating notification and laboratory data for meningococcal disease.
- Since 1991, incidence rates have escalated, reaching 6.2 per 100,000 in 1994, a fourfold increase from 1989/90.
- Serogroup B is the predominant strain, with elevated rates potentially persisting for 5–15 years.
Purpose of the Study:
- To analyze trends and demographic disparities in meningococcal disease incidence in New Zealand.
- To highlight the disproportionately high rates in Maori and Pacific Islands populations, especially infants.
- To evaluate the case fatality rate and suggest future research directions.
Main Methods:
- Analysis of integrated notification and laboratory data for meningococcal disease surveillance.
- Calculation of incidence rates per 100,000 population, stratified by ethnicity and age group.
- Review of case fatality rates and comparison with international standards.
Main Results:
- Meningococcal disease incidence peaked at 6.2 per 100,000 in 1994.
- Maori and Pacific Islands populations experienced rates three times higher than Europeans (10.0 and 12.3 per 100,000, respectively) in 1994.
- Maori infants under one year had exceptionally high rates, reaching 120 per 100,000.
Conclusions:
- Meningococcal disease remains a significant public health issue in New Zealand, with notable ethnic and age-related disparities.
- The case fatality rate of 5.3% in 1994 is considered relatively low internationally.
- Case-control and intensive case review studies are recommended to identify modifiable risk factors and effective interventions.