title: Epidemic meningococcal disease in Nairobi, Kenya, 1989. The Kenya/Centers for Disease Control (CDC) Meningitis Study Group.
abstract: 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.
authors.affiliation: Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, GA 30333.
authors.forename: R W
authors.initials: RW
authors.lastname: Pinner
authors.forename: F
authors.initials: F
authors.lastname: Onyango
authors.forename: B A
authors.initials: BA
authors.lastname: Perkins
authors.forename: N B
authors.initials: NB
authors.lastname: Mirza
authors.forename: D M
authors.initials: DM
authors.lastname: Ngacha
authors.forename: M
authors.initials: M
authors.lastname: Reeves
authors.forename: W
authors.initials: W
authors.lastname: DeWitt
authors.forename: E
authors.initials: E
authors.lastname: Njeru
authors.forename: N N
authors.initials: NN
authors.lastname: Agata
authors.forename: C V
authors.initials: CV
authors.lastname: Broome
mesh_terms: 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
chemical_list: D001428:Bacterial Vaccines; D004798:Enzymes; D022401:Meningococcal Vaccines