title: Outbreak of Neisseria meningitidis C in workers at a large food-processing plant in Brazil: challenges of controlling disease spread to the larger community.
abstract: SUMMARYAn outbreak of meningococcal disease (MD) with severe morbidity and mortality was investigated in midwestern Brazil in order to identify control measures. A MD case was defined as isolation of Neisseria meningitidis, or detection of polysaccharide antigen in a sterile site, or presence of clinical purpura fulminans, or an epidemiological link with a laboratory-confirmed case-patient, between June and August 2008. In 8 out of 16 MD cases studied, serogroup C ST103 complex was identified. Five (31%) cases had neurological findings and five (31%) died. The attack rate was 12 cases/100 000 town residents and 60 cases/100 000 employees in a large local food-processing plant. We conducted a matched case-control study of eight primary laboratory-confirmed cases (1:4). Factors associated with illness in single variable analysis were work at the processing plant [matched odds ratio (mOR) 22, 95% confidence interval (CI) 2·3-207·7, P<0·01], and residing <1 year in Rio Verde (mOR 7, 95% CI 1·11-43·9, P<0·02). Mass vaccination (>10 000 plant employees) stopped propagation in the plant, but not in the larger community.
authors.affiliation: Field Epidemiology Training Program, Centre for Strategic Information in Health Surveillance, Secretariat of Health Surveillance, Ministry of Health, Brazil. betine.iser@saude.gov.br
authors.forename: B P M
authors.initials: BP
authors.lastname: Iser
authors.forename: H C A V
authors.initials: HC
authors.lastname: Lima
authors.forename: C
authors.initials: C
authors.lastname: de Moraes
authors.forename: R P A
authors.initials: RP
authors.lastname: de Almeida
authors.forename: L T
authors.initials: LT
authors.lastname: Watanabe
authors.forename: S L A
authors.initials: SL
authors.lastname: Alves
authors.forename: A P S
authors.initials: AP
authors.lastname: Lemos
authors.forename: M C O
authors.initials: MC
authors.lastname: Gorla
authors.forename: M G
authors.initials: MG
authors.lastname: Gonçalves
authors.forename: D A
authors.initials: DA
authors.lastname: Dos Santos
authors.forename: J
authors.initials: J
authors.lastname: Sobel
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology / Q000401:mortality / Q000517:prevention & control; D004196:Disease Outbreaks; D005260:Female; D005511:Food Handling; D006801:Humans; D007223:Infant; D017053:Infection Control / Q000379:methods*; D008297:Male; D032541:Mass Vaccination / Q000379:methods; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality / Q000517:prevention & control; D008875:Middle Aged; D038542:Neisseria meningitidis, Serogroup C / Q000302:isolation & purification*; D016273:Occupational Exposure; D022242:Pneumococcal Vaccines / Q000008:administration & dosage; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D022242:Pneumococcal Vaccines