title: Control of group C meningococcal disease in Australian aboriginal children by mass rifampicin chemoprophylaxis and vaccination.
abstract: An outbreak of 12 cases of meningitis, 11 caused by Neisseria meningitidis serogroup C, occurred at Doomadgee from September, 1990, to April, 1991. The incidence of meningitis was 17.55/10(3) person-years. Only children aged 1-10 years were affected. In October, 1990, or shortly thereafter, 473/509 children aged between 1 and 15 years inclusive had one dose of Mencevax AC. From the time of vaccination until April, 1991, a further eight cases occurred, six in vaccinated children. Vaccine efficacy in 1-15 year olds was calculated as 77%. Despite this, in April, 1991, the prevalence of antibody to group C polysaccharide in vaccinated children (78%) was not significantly different from that in unvaccinated children and adults. 46 nonresponders were revaccinated, and, in February, 1992, 78% had antibodies to group C polysaccharide. In April, 1991, an estimated 3.0% of the population had group C organisms, carriage being directly related to household crowding. In June, 1991, 2 months after mass prophylaxis with rifampicin, none of these individuals were carriers. In October, 1991, the carriage rate of group C organisms was 0.64%. There have been no further cases caused by the epidemic strain. Although uncrowded housing is a basic need, mass chemoprophylaxis and two doses of vaccine for children should be used in similar outbreaks.
authors.affiliation: Communicable Diseases Branch, Queensland Health, Brisbane, Australia.
authors.forename: M C
authors.initials: MC
authors.lastname: Pearce
authors.forename: J W
authors.initials: JW
authors.lastname: Sheridan
authors.forename: D M
authors.initials: DM
authors.lastname: Jones
authors.forename: G W
authors.initials: GW
authors.lastname: Lawrence
authors.forename: D M
authors.initials: DM
authors.lastname: Murphy
authors.forename: B
authors.initials: B
authors.lastname: Masutti
authors.forename: C
authors.initials: C
authors.lastname: McCosker
authors.forename: V
authors.initials: V
authors.lastname: Douglas
authors.forename: D
authors.initials: D
authors.lastname: George
authors.forename: A
authors.initials: A
authors.lastname: O'Keefe
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D001428:Bacterial Vaccines / Q000627:therapeutic use*; D002353:Carrier State / Q000208:ethnology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks / Q000517:prevention & control / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007117:Immunization, Secondary; D015994:Incidence; D007223:Infant; D008297:Male; D008585:Meningitis, Meningococcal / Q000208:ethnology / Q000517:prevention & control*; D022401:Meningococcal Vaccines; D009345:Neisseria meningitidis / Q000276:immunology*; D011135:Polysaccharides, Bacterial / Q000627:therapeutic use*; D012293:Rifampin / Q000627:therapeutic use*
chemical_list: D001428:Bacterial Vaccines; C094429:Mencevax AC; D022401:Meningococcal Vaccines; D011135:Polysaccharides, Bacterial; D012293:Rifampin