title: Serotype-specific outbreak of group B meningococcal disease in Iquique, Chile.
abstract: From 1979 to August 1987, there have been 178 cases of meningococcal disease in Iquique, Chile, a city of about 140,000. The attack rate for the last 5 years has been in excess of 20/100,000 per year, more than 20 times greater than for the country overall. The mortality rate was 6%. The disease occurred in patients with ages from 4 months to 60 years, but 89% of cases were in patients less than 21 years. The largest number of cases were in the age group 5-9 years (n = 54), but the highest incidence occurred in children less than 1 year of age (72.8/100,000 per year). The male/female ratio was 1.2. Cases occurred all year round with little seasonal variation. Of the 178 cases, 173 were biologically confirmed. Serogroup analysis of strains from 135 patients revealed A = 1, B = 124, C = 10. Forty-four group B strains from 1985-7 were serotyped: 15:P1.3 = 36, 15:NT = 4, 4:P1.3 = 2, NT:NT = 2. Ten of 11 of the outbreak strains tested were sulfadiazine-resistant. This is the first recognized outbreak caused by a Gp B:15 strain in South America. It shares many of the characteristics of outbreaks caused by closely related strains in Europe, such as a predilection for older children and adolescents, sulfadiazine-resistance, and sustained high attack rates. The Iquique strain (B:15:P1.3) belongs to the same genetic clone (ET-5 complex) as the Norway (B:15:P1.16) and the Cuban (B:4:P1.15) strains.
authors.affiliation: Iquique Health Service, Chile.
authors.forename: C
authors.initials: C
authors.lastname: Cruz
authors.forename: G
authors.initials: G
authors.lastname: Pavez
authors.forename: E
authors.initials: E
authors.lastname: Aguilar
authors.forename: L
authors.initials: L
authors.lastname: Grawe
authors.forename: J
authors.initials: J
authors.lastname: Cam
authors.forename: F
authors.initials: F
authors.lastname: Mendez
authors.forename: J
authors.initials: J
authors.lastname: Garcia
authors.forename: S
authors.initials: S
authors.lastname: Ruiz
authors.forename: P
authors.initials: P
authors.lastname: Vicent
authors.forename: I
authors.initials: I
authors.lastname: Canepa
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D002677:Chile / Q000453:epidemiology; D002980:Climate; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification; D011379:Prognosis; D012621:Seasons; D018805:Sepsis / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality; D012703:Serotyping; D014505:Urban Population