title: Meningococcal disease in South Africa, 1999-2002.
abstract: We describe the epidemiology of invasive meningococcal disease in South Africa from August 1999 through July 2002, as reported to a laboratory-based surveillance system. Neisseria meningitidis isolates were further characterized. In total, 854 cases of laboratory-confirmed disease were reported, with an annual incidence rate of 0.64/100,000 population. Incidence was highest in infants < 1 year of age. Serogroup B caused 41% of cases; serogroup A, 23%; serogroup Y, 21%; serogroup C, 8%; and serogroup W135, 5%. Serogroup B was the predominant serogroup in Western Cape Province, and disease rates remained stable. Serogroup A was most prevalent in Gauteng Province and increased over the 3 years. On pulsed-field gel electrophoresis analysis, serogroup A strains showed clonality, and serogroup B demonstrated considerable diversity. Selected isolates of serogroup A belonged to sequence type (ST)-1 (subgroup I/II) complex, serogroup B to ST-32/electrophoretic type (ET)-5 complex, and serogroup W135 to ST-11/ET-37 complex.
authors.affiliation: National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
authors.forename: Garry B
authors.initials: GB
authors.lastname: Coulson
authors.forename: Anne
authors.initials: A
authors.lastname: von Gottberg
authors.forename: Mignon
authors.initials: M
authors.lastname: du Plessis
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Smith
authors.forename: Linda
authors.initials: L
authors.lastname: de Gouveia
authors.forename: Keith P
authors.initials: KP
authors.lastname: Klugman
mesh_terms: D006801:Humans; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D017720:Molecular Epidemiology; D009345:Neisseria meningitidis / Q000145:classification; D012703:Serotyping; D013019:South Africa / Q000453:epidemiology