title: The changing epidemiology of meningococcal disease in the United States, 1992-1996.
abstract: New meningococcal vaccines are undergoing clinical trials, and changes in the epidemiologic features of meningococcal disease will affect their use. Active laboratory-based, population-based US surveillance for meningococcal disease during 1992-1996 was used to project that 2400 cases of meningococcal disease occurred annually. Incidence was highest in infants; however, 32% of cases occurred in persons >/=30 years of age. Serogroup C caused 35% of cases; serogroup B, 32%; and serogroup Y, 26%. Increasing age (relative risk [RR], 1.01 per year), having an isolate obtained from blood (RR, 4.5), and serogroup C (RR, 1.6) were associated with increased case fatality. Among serogroup B isolates, the most commonly expressed serosubtype was P1.15; 68% of isolates expressed 1 of the 6 most common serosubtypes. Compared with cases occurring in previous years, recent cases are more likely to be caused by serogroup Y and to occur among older age groups. Ongoing surveillance is necessary to determine the stability of serogroup and serosubtype distribution.
authors.affiliation: Division of Bacterial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. NAR5@cdc.gov
authors.forename: N E
authors.initials: NE
authors.lastname: Rosenstein
authors.forename: B A
authors.initials: BA
authors.lastname: Perkins
authors.forename: D S
authors.initials: DS
authors.lastname: Stephens
authors.forename: L
authors.initials: L
authors.lastname: Lefkowitz
authors.forename: M L
authors.initials: ML
authors.lastname: Cartter
authors.forename: R
authors.initials: R
authors.lastname: Danila
authors.forename: P
authors.initials: P
authors.lastname: Cieslak
authors.forename: K A
authors.initials: KA
authors.lastname: Shutt
authors.forename: T
authors.initials: T
authors.lastname: Popovic
authors.forename: A
authors.initials: A
authors.lastname: Schuchat
authors.forename: L H
authors.initials: LH
authors.lastname: Harrison
authors.forename: A L
authors.initials: AL
authors.lastname: Reingold
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004586:Electrophoresis / Q000379:methods; D004798:Enzymes / Q000032:analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology*; D008875:Middle Aged; D009345:Neisseria meningitidis / Q000145:classification* / Q000302:isolation & purification; D011159:Population Surveillance; D015995:Prevalence; D012621:Seasons; D012703:Serotyping; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology
chemical_list: D004798:Enzymes