title: Molecular epidemiology of sporadic (endemic) serogroup C meningococcal disease.
abstract: Understanding the basis of sporadic (endemic) meningococcal disease may be critical to prevention of meningococcal epidemic outbreaks and to understanding fluctuations in incidence. Active, prospective, population-based surveillance and molecular epidemiologic techniques were used to study sporadic serogroup C meningococcal disease in a population of 2.34 million persons (Atlanta area). During 1988-1994, in which no outbreaks or case clusters were reported, 71 patients developed sporadic serogroup C meningococcal disease (annual incidence, 0.51/100,000). Eighty-three percent of patients were >2 years old. By multilocus enzyme electrophoresis, pulsed-field gel electrophoresis, and serotyping, 84% (52/62) of the isolates available for study were identical or closely related members of the electrophoretic type 37 (ET 37) complex responsible for multiple serogroup C outbreaks in the United States in the 1990s. Sporadic disease caused by 9 clonal strains occurred over periods up to 4 years and accounted for 45% (28/62) of cases. Sporadic serogroup C meningococcal disease was most often due to a limited number of related strains that appear to slowly circulate in the population.
authors.affiliation: Emory University School of Medicine, Department of Veterans Affairs Medical Center, and Centers for Disease Control and Prevention, Atlanta, Georgia 30303, USA.
authors.forename: N J
authors.initials: NJ
authors.lastname: Raymond
authors.forename: M
authors.initials: M
authors.lastname: Reeves
authors.forename: G
authors.initials: G
authors.lastname: Ajello
authors.forename: W
authors.initials: W
authors.lastname: Baughman
authors.forename: L L
authors.initials: LL
authors.lastname: Gheesling
authors.forename: G M
authors.initials: GM
authors.lastname: Carlone
authors.forename: J D
authors.initials: JD
authors.lastname: Wenger
authors.forename: D S
authors.initials: DS
authors.lastname: Stephens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification*; D012703:Serotyping