Assessment of surveillance for meningococcal disease in New York State, 1991

Prevention of meningococcal disease relies in part on the prompt treatment of household and other close contacts of cases. New York State requires that all meningococcal disease cases be reported within 24 hours of diagnosis to ensure that chemoprophylaxis is given to all exposed persons. The authors used a capture-recapture method to assess completeness of reporting of meningococcal disease in 1991 by comparing persons reported to the Department of Health surveillance system with patients listed in the New York State computerized hospital discharge data set who had a discharge diagnosis of meningococcal disease. Medical records of persons identified from the discharge data set were reviewed to verify the diagnosis of meningococcal disease, and timeliness of reporting was assessed by reviewing surveillance case reports. In 1991, 110 cases of meningococcal disease were reported to the Department of Health and 197 patients were identified from hospital discharge data, of which charts were reviewed for 179 (91%). Of the charts reviewed, 116 (65%) had confirmed or probable meningococcal disease, and 57 (32%) did not have the disease. Completeness of reporting to the notifiable disease surveillance system was estimated to be 93%, and 78% were reported within 2 days of diagnosis. Errors of physicians and medical records departments contributed to the misclassification of medical records. The authors conclude that notifiable disease surveillance for meningococcal disease is relatively complete, but there is a delay in reporting some cases. Frequent errors may make invalidated hospital discharge data unsuitable for communicable disease surveillance.