Epidemic meningococcal disease in Nairobi, Kenya, 1989. The Kenya/Centers for Disease Control (CDC) Meningitis Study Group.
An epidemic of meningococcal disease occurred in Nairobi, Kenya, during 1989, outside the "meningitis belt" of sub-Saharan Africa. About 3800 cases occurred between April and November (250/100,000 population). The case-fatality rate was 9.4% among hospitalized patients. Areas that included Nairobi's largest slums had particularly high attack rates. The epidemic displayed an unusual age distribution, with high attack rates among those 20-29 years old. A vaccination campaign was conducted. By early January, the weekly case count had fallen to 25 from a high of 272 (in September). A case-control study estimated the vaccine efficacy to be 87% (95% confidence interval, 67%-95%). A model estimated that the vaccination campaign reduced the number of cases by at least 20%. Multilocus enzyme electrophoretic typing demonstrated that the strain responsible for this large epidemic is closely related to strains that caused other recent epidemics, documenting further spread of what may be a particularly virulent clonal complex of group A Neisseria meningitidis.
Pinner
R W
RW
Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, GA 30333.
Onyango
F
F
Perkins
B A
BA
Mirza
N B
NB
Ngacha
D M
DM
Reeves
M
M
DeWitt
W
W
Njeru
E
E
Agata
N N
NN
Broome
C V
CV
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001428:Bacterial Vaccines; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004798:Enzymes / Q000032:analysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008589:Meningococcal Infections / Q000134:cerebrospinal fluid / Q000453:epidemiology* / Q000517:prevention & control; D022401:Meningococcal Vaccines; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification / Q000201:enzymology / Q000302:isolation & purification; D011204:Poverty Areas; D014611:Vaccination
D001428:Bacterial Vaccines; D004798:Enzymes; D022401:Meningococcal Vaccines