title: Invasive meningococcal disease in adolescents and young adults.
abstract: BACKGROUND
  Incidence of invasive meningococcal disease has increased recently in persons aged 15 through 24 years.
  
  
  OBJECTIVE
  To characterize meningococcal infection in adolescents and young adults in Maryland during the 1990s.
  
  
  METHODS
  Population-based surveillance study for meningococcal disease from January 1, 1990, through December 31, 1999, in Maryland.
  
  
  METHODS
  Maryland residents diagnosed as having invasive meningococcal disease.
  
  
  METHODS
  Invasive meningococcal infection.
  
  
  RESULTS
  Of 295 total cases, 71 (24.1%) occurred among persons aged 15 through 24 years. Sixteen (22.5%) of these cases were fatal. The annual incidence rate increased from 0.9 to 2.1 cases per 100 000 among 15 through 24 year olds (P =.01). The proportion of all disease increased from 16.0% to 28.9% (P =.03). The incidence and proportion of cases subsequently decreased to 1.0 and 16.4% in 1998 through 1999, respectively. Infection in 15 through 24 year olds was more likely to be fatal than infection in those younger than age 15 years (22.5% vs 4.6%; P =.001). Infection in 15 through 24 year olds, compared with those aged 25 years or older, was more likely to be associated with male sex (66.2% vs 34.8%; P<.001) and serogroup C infection (46.9% vs 20.2%; P<.001), respectively. Infections were potentially preventable with the licensed meningococcal vaccine in 82.8% of 15 through 24 year olds, 68.1% of those younger than 15 years, and 76.8% of adults aged 25 years or older.
  
  
  CONCLUSIONS
  Incidence of meningococcal infection in 15 through 24 year olds in Maryland increased and then declined during the 1990s. Infection in this age group was associated with an unusually high case-fatality ratio, and the vast majority of cases were potentially vaccine preventable.
authors.affiliation: Infectious Diseases Epidemiology Research Unit, University of Pittsburgh, 521 Parran Hall, 130 DeSoto St, Pittsburgh, PA 15261, USA. lharriso@edc.gsph.pitt.edu
authors.forename: L H
authors.initials: LH
authors.lastname: Harrison
authors.forename: M A
authors.initials: MA
authors.lastname: Pass
authors.forename: A B
authors.initials: AB
authors.lastname: Mendelsohn
authors.forename: M
authors.initials: M
authors.lastname: Egri
authors.forename: N E
authors.initials: NE
authors.lastname: Rosenstein
authors.forename: A
authors.initials: A
authors.lastname: Bustamante
authors.forename: J
authors.initials: J
authors.lastname: Razeq
authors.forename: J C
authors.initials: JC
authors.lastname: Roche
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008396:Maryland / Q000453:epidemiology; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D022401:Meningococcal Vaccines; D009345:Neisseria meningitidis / Q000145:classification; D011159:Population Surveillance; D012703:Serotyping; D014611:Vaccination
chemical_list: D022401:Meningococcal Vaccines