Neonatal meningococcal disease in the United States, 1990 to 1999.
BACKGROUND
Although neonatal bacterial meningitis is common, the rate of invasive meningococcal disease in the United States among children < or =30 days old has not been defined. Most relevant literature consists of case reports or case series, which note high case-fatality ratios but do not describe the overall burden of disease.


METHODS
We used active, population-based surveillance data from the Active Bacterial Core Surveillance program to estimate the incidence of neonatal meningococcal disease in the United States from 1990 to 1999. A case of neonatal meningococcal disease was defined as isolation of Neisseria meningitidis from a normally sterile site in a resident of the surveillance area < or =30 days of age.


RESULTS
The median annual number of neonates under surveillance was 25 900. Between 1990 and 1999, 22 cases of neonatal meningococcal disease were identified. Three (14%) patients died. The average annual incidence was 9 per 100 000.


CONCLUSIONS
The rate of neonatal meningococcal disease in the United States is higher than previous estimates. Meningococcal disease is uncommon in neonates, but its rate is similar to that of meningococcal disease in 6- to 23-month-old children.
Shepard
Colin W
CW
Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Disease/CDC, 1600 Clifton Road NE, Atlanta, GA 30333, USA. cvs8@cdc.gov
Rosenstein
Nancy E
NE
Fischer
Marc
M
D017677:Age Distribution; D016470:Bacteremia / Q000175:diagnosis / Q000453:epidemiology*; D016009:Chi-Square Distribution; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008585:Meningitis, Meningococcal / Q000175:diagnosis / Q000453:epidemiology; D008589:Meningococcal Infections / Q000175:diagnosis / Q000453:epidemiology*; D009345:Neisseria meningitidis / Q000302:isolation & purification*; D011159:Population Surveillance; D011336:Probability; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology