The Changing Epidemiology of Meningococcal Disease in the United States, 1992–1996

TLDR

New meningococcal vaccines are undergoing clinical trials, and changes in the epidemiologic features of meningococcal disease will affect their use. Ongoing surveillance is necessary to determine the stability of serogroup and serosubtype distribution. Active laboratory‑based, population‑based US surveillance for meningococcal disease during 1992–1996 was used to project that 2400 cases of meningococcal disease occurred annually. Incidence was highest in infants, yet 32% of cases occurred in adults ≥30; serogroup C, B, and Y comprised 35%, 32%, and 26% of cases, with older age, blood isolates, and serogroup C associated with higher fatality; serogroup B isolates predominantly expressed serosubtype P1 and 68% of isolates were among the six most common serosubtypes, and recent cases were more likely serogroup Y and in older age groups.

Abstract

New meningococcal vaccines are undergoing clinical trials, and changes in the epidemiologic features of meningococcal disease will affect their use. Active laboratory-based, population-based US surveillance for meningococcal disease during 1992–1996 was used to project that 2400 cases of meningococcal disease occurred annually. Incidence was highest in infants; however, 32% of cases occurred in persons ⩾30 years of age. Serogroup C caused 35% of cases; serogroup B, 32%; and serogroup Y, 26%. Increasing age (relative risk [RR], 1.01 per year), having an isolate obtained from blood (RR, 4.5), and serogroup C (RR, 1.6) were associated with increased case fatality. Among serogroup B isolates, the most commonly expressed serosubtype was P1. 15; 68% of isolates expressed 1 of the 6 most common sero-subtypes. Compared with cases occurring in previous years, recent cases are more likely to be caused by serogroup Y and to occur among older age groups. Ongoing surveillance is necessary to determine the stability of serogroup and serosubtype distribution.