title: Incidence, serogroups and case-fatality rate of invasive meningococcal infections in a Swedish region 1975-1989.
abstract: In a retrospective study of invasive meningococcal infections in Greater Gothenburg, Sweden, 213 cases of culture-verified meningitis or septicaemia were identified during the 15-year period 1975-1989. The annual incidence was 2.0/100,000. Cases were seen in all age-groups with the highest rates in the 0-4 and 15-19 year-old groups, 9.5 and 6.2/100,000 respectively. 20% of the patients were less than 2 years. 91% of the patients had no known risk factors. In only 10 cases (5%) was contact with another case of meningococcal infection known. The main clinical manifestations were meningitis (57%), septicaemia with no sign of focal infection (25%) and septic shock (17%). The case-fatality rate for all the patients was 6.6% and did not change during the 15-year period. One-third of the patients who presented with septic shock died. The serogroup was known for strains from 192 patients. 51% of the strains belonged to serogroup B, 10% to group A and 23% to group C. In conclusion, the incidence of meningococcal infection was low but the relatively high case-fatality rate warrants a search for effective prophylaxis. About 30% of the cases were potentially preventable by the currently available tetravalent (A, C, Y and W135) polysaccharide vaccine, which is immunogenic in children greater than 2 years. Widespread use of antibiotic prophylaxis to close contacts of known cases would not lower the incidence markedly.
authors.affiliation: Department of Paediatrics, Mölndal Hospital, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Berg
authors.forename: B
authors.initials: B
authors.lastname: Trollfors
authors.forename: K
authors.initials: K
authors.lastname: Alestig
authors.forename: U
authors.initials: U
authors.lastname: Jodal
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D009345:Neisseria meningitidis / Q000145:classification; D012189:Retrospective Studies; D012703:Serotyping; D013548:Sweden / Q000453:epidemiology