The changing epidemiology of meningococcal disease in the United States, 1992-1996.
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.
Rosenstein
N E
NE
Division of Bacterial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. NAR5@cdc.gov
Perkins
B A
BA
Stephens
D S
DS
Lefkowitz
L
L
Cartter
M L
ML
Danila
R
R
Cieslak
P
P
Shutt
K A
KA
Popovic
T
T
Schuchat
A
A
Harrison
L H
LH
Reingold
A L
AL
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
D004798:Enzymes