The epidemiology of Neisseria meningitidis is changing. The incidence of disease in young adults has increased and serogroup proportions have shifted. We examined trends in incidence, age and serogroup for the years 1990-98 in the Eastern Health District of Missouri. Our sample consisted of 265 reported cases. Surveillance data included demographics, laboratory and outcome data. County and age-specific rates were computed for each year and compared. The proportion of isolates serogrouped and serogroup incidence were also examined. There were 192 confirmed cases and 73 probable cases. The average annual incidence was 1.56 cases per 105 population. A significant trend during the period was noted with a near five-fold increase from 0.50 cases per 105 in 1990 to 2.4 cases per 105 in 1998. The median age during 1990-93 was 6 years of age and increased by 6 years for each successive three–year interval. In 121 (63%) of confirmed cases a serogroup was identified. There were 50 (41%) serogroup C, 39 (32%) serogroup Y, 28 (23%) serogroup B, and 4 (3%) other or ungrouped. The overall case fatality rate was 15.6%. Both the incidence and median age of N. meningitidis cases has increased. The results also indicate that routine submission of meningococcal isolates is less than desirable. This has prompted a Missouri Department of Health rule change making isolate submission mandatory. Electronic notification of a reported case of N. meningitidis to the Missouri Health Department Laboratory to facilitate the tracking of isolate submission has also been proposed.
Learning Objectives: At the conclusion of the presentation the participant shall be able to: 1) Discuss the changing epidemiology of meningococal infections and the implications for public health. 2) Recognize the importance of serogroup identification in meningococcal disease surveillance and prevention. 3) Indentify potential policy changes to improve meningococcal disease surveillance
Keywords: Communicable Disease, Adolescent Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.