title: A cluster of meningococcal disease on a school bus following epidemic influenza.
abstract: An outbreak of meningococcal disease among children on a school bus offered the opportunity to study a proposed association between this infection and preceding influenza infection. Five students who rode the bus became ill with invasive group C meningococcus. Transmission was limited to the bus; there was no evidence for school transmission. All five students reported influenza-like symptoms within several weeks before the development of meningococcal disease. School absenteeism, principally due to upper respiratory tract illness, was higher during the 3 weeks before the outbreak of meningococcal disease than during any period in the preceding 3 1/2 years, suggesting an unusually severe outbreak of respiratory illness. A case-control study comparing students with and without influenza symptoms revealed that the outbreak of respiratory disease was due to B/Ann Arbor/1/86 influenza (geometric mean titers, 86 for 80 patients and 33 for 47 controls [P = .0007]). These data add to the evidence suggesting that influenza respiratory infection predisposes to meningococcal disease.
authors.affiliation: Meningitis and Special Pathogens Branch, Centers for Disease Control, Atlanta, GA 30333.
authors.forename: L H
authors.initials: LH
authors.lastname: Harrison
authors.forename: C W
authors.initials: CW
authors.lastname: Armstrong
authors.forename: S R
authors.initials: SR
authors.lastname: Jenkins
authors.forename: M W
authors.initials: MW
authors.lastname: Harmon
authors.forename: G W
authors.initials: GW
authors.lastname: Ajello
authors.forename: G B
authors.initials: GB
authors.lastname: Miller
authors.forename: C V
authors.initials: CV
authors.lastname: Broome
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D004196:Disease Outbreaks; D006801:Humans; D015994:Incidence; D007251:Influenza, Human / Q000453:epidemiology*; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission; D012307:Risk Factors; D014186:Transportation; D014768:Virginia / Q000453:epidemiology