Clinical features and outcome of sporadic serogroup W135 disease Taiwan.
BACKGROUND
Few published reports have evaluated the clinical features and outcome of serogroup W135 meningococcal disease. In Taiwan, W135 is the second most prevalent meningococcal disease serogroup.


METHODS
A nationwide study was conducted to retrospectively analyze epidemiologic data from 115 patients with laboratory confirmed meningococcal disease that occurred from 2001 through 2003.


RESULTS
Serogroup W135 accounted for 26% of all cases and most (76.7%) were older than 20 years. There were no cases of serogroup W135 meningococcal disease associated with Hajj pilgrims, and all cases were sporadic. In 88 patients with complete case records, we compared the presenting symptoms, signs, laboratory data, and outcomes between W135 and non-W135 patients. There were no differences in presenting symptoms except for the higher prevalence of pneumonia found in W135 patients (23.8% vs. 1.5%; OR: 20.6; 95%CI: 2.3-189.0; p = 0.003). The distribution of inflammatory cells in CSF in patients with meningitis was also different between W135 and non-W135 patients. W135 patients had a trend toward more intubations and shock but it did not achieve statistical significance. In multivariate analysis of factors associated with death, three independent factors were found: bacteremia without meningitis, altered mental status, and petechiae or purpura on admission.


CONCLUSIONS
Sporadic serogroup W135 meningococcal disease is an important component of the meningococcal disease burden in Taiwan, but it is not directly associated with Hajj pilgrims. Compared with patients infected by other serogroups of meningococci, patients with serogroup W135 were older and more likely to have extrameningeal involvement such as pneumonia.
Wang
Jiun-Ling
JL
Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, Taipei, Taiwan. jlwang@ntumc.org
Liu
Ding-Ping
DP
Yen
Jer-Jea
JJ
Yu
Chia-Jung
CJ
Liu
Hsi-Chen
HC
Lin
Ching-Yuang
CY
Chang
Shan-Chwen
SC
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D008875:Middle Aged; D015999:Multivariate Analysis; D038582:Neisseria meningitidis, Serogroup W-135 / Q000302:isolation & purification*; D013624:Taiwan / Q000453:epidemiology