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A college outbreak of group C meningococcal infection: how widely should investigation and prophylaxis extend?
1Exeter Public Health Laboratory, Heavitree.
Abstract:
Neisseria meningitidis group C type 2b, P1.2, P1.5 caused an outbreak of four cases, two of whom were members of an agricultural college in Devon, and two outside contacts of students who were documented carriers of the outbreak strain. The identification of the outbreak was made more difficult by the fact that none of the three cases first linked with the college was culture positive and indeed only one of these was actually a member of the college. Carriage of the outbreak strain was significantly associated with residence in college and enrollment on one particular course. The question was raised of whether in outbreaks of this type control measures should be extended beyond the confines of the affected institution.
Insights
An agricultural college experienced a Neisseria meningitidis outbreak. Control measures for such outbreaks may need to extend beyond the institution to include contacts.
Area of Science:
- Microbiology
- Epidemiology
- Public Health
Background:
- Neisseria meningitidis (meningococcus) is a significant cause of bacterial meningitis and sepsis.
- Group C meningococcal disease outbreaks can occur in closed communities like educational institutions.
Observation:
- An outbreak of four meningococcal disease cases (group C, type 2b, P1.2, P1.5) was identified.
- Two cases were linked to an agricultural college; two were outside contacts of student carriers.
- Diagnostic challenges arose as initial cases linked to the college were not culture-positive.
Findings:
- Carriage of the specific outbreak strain was strongly associated with college residence and a particular course.
- The outbreak strain was identified as Neisseria meningitidis group C, type 2b, P1.2, P1.5.
Implications:
- The findings raise questions about the scope of control measures for institutional outbreaks.
- Consideration should be given to extending interventions beyond the immediate institution to include close contacts.