title: Unusual cluster of mild invasive serogroup C meningococcal infection in a university college.
abstract: The objective of this study was to describe the epidemiology and public health response to an apparent cluster of Neisseria meningitidis serogroup C infection in university students in a residential college. A conventional epidemiological approach was taken, supported by routine and novel diagnostic techniques. Over the two days of 21-22 August 1997, three cases of suspected meningococcal infection were notified from a residential college complex at a university campus in the Sydney metropolitan area. Neisseria meningitidis was grown from throat swabs of all three cases, and was isolated from the blood of one case only. All three isolates were typed as C:2a:P1.5,2. Seroconversion was demonstrated by a novel method in the three cases. Rifampicin was given to all identified contacts. Forty-seven days after the index case, a 19 year old female living in the same complex was diagnosed with bacterial meningitis, and identified contacts given rifampicin. When this isolate was found to be group C, it was decided to vaccinate residents of the college complex. Genotyping and serotyping (C:2a:P1.5) later revealed the fourth isolate to be distinct from isolates from Cases 1-3. In conclusion the authors note that Australia's increasing capacity to type meningococcal strains is essential to understanding the epidemiology of this disease. Furthermore, typing information is of critical importance when decisions are made regarding mass vaccination. As early antibiotic treatment may inhibit isolation of the organism, development of novel approaches to diagnosis and typing should be supported.
authors.affiliation: South Eastern Sydney Public Health Unit, Zetland, New South Wales. mfers@doh.health.nsw.gov.au
authors.forename: M
authors.initials: M
authors.lastname: Ferson
authors.forename: L
authors.initials: L
authors.lastname: Young
authors.forename: G
authors.initials: G
authors.lastname: Hansen
authors.forename: J
authors.initials: J
authors.lastname: Post
authors.forename: J
authors.initials: J
authors.lastname: Tapsall
authors.forename: T
authors.initials: T
authors.lastname: Shultz
authors.forename: A
authors.initials: A
authors.lastname: Limnios
authors.forename: D
authors.initials: D
authors.lastname: Lee
authors.forename: P
authors.initials: P
authors.lastname: Reinbott
authors.forename: Y
authors.initials: Y
authors.lastname: Duffy
authors.forename: P
authors.initials: P
authors.lastname: Robertson
authors.forename: P
authors.initials: P
authors.lastname: Jones
authors.forename: G
authors.initials: G
authors.lastname: Pontivivo
authors.forename: K
authors.initials: K
authors.lastname: Morgan
mesh_terms: D000293:Adolescent; D000328:Adult; D016000:Cluster Analysis; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008585:Meningitis, Meningococcal / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D009345:Neisseria meningitidis / Q000302:isolation & purification*; D011135:Polysaccharides, Bacterial / Q000032:analysis; D012293:Rifampin / Q000627:therapeutic use; D012307:Risk Factors; D012698:Serologic Tests; D012720:Severity of Illness Index; D014495:Universities; D014852:Wales / Q000453:epidemiology
chemical_list: D011135:Polysaccharides, Bacterial; D012293:Rifampin