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Thought this might be of interest:
Subject:PRO> Meningococcal disease - international
Date: Fri, 10 Oct 1997 23:05:57 -0400 (EDT)
From: ProMED-mail <promed@usa.healthnet.org>
To: promed@usa.healthnet.org
MENINGOCOCCAL DISEASE - INTERNATIONAL
*************************************
A ProMED-mail Post
[see also:
Meningococcal disease, management of clusters (03) 970225172255]
Date: Fri, 10 Oct 1997
From: Dorothy Preslar
Source: EuroWeekly <eurowkly@eurosurv.org>
The latest issue of Eurosurveillance monthly
<http://www.b3e.jussieu.fr:80/ceses/eurosurv/> is devoted to meningococcal disease, with reports from six member states of the European Union that outline similarities and differences in trends over the past few years (1).
The annual incidence of meningococcal disease varies in these countries by a factor of five, between 1 and 5 cases per 100,000 population. The prevailing trend recently has been an increasing incidence of infections caused by serogroup C strains of Neisseria meningitidis, but Belgium and France have seen an increase in group B strains.
Data on bacterial meningitis from the United States published recently in the New England Journal of Medicine come from a sentinel group of
laboratories in four states, representing a population of 10 million (2).
The incidence of meningococcal meningitis was 0.6 cases per 100,000
population in 1995, a fall of one third from the incidence of 0.9/100,000 in 1986, but the incidence of invasive meningococcal disease overall was 1.3/100,000 in 1986 and 1995. N. meningitidis of serogroup C predominated in three of the sentinel states and serogroup Y in the fourth.
The tragedy of individual cases of meningococcal disease is multiplied
100-fold in Africa, where in the first three months of 1997 over 40,000 cases of meningitis (mainly serogroup A but unlikely to be tested) and almost 4,500 deaths had been reported (3). Forty per cent of the cases were from Burkina Faso, in west Africa, where a crude incidence for the period was 186 cases per 100,000 population (16,775/9 million).
Contrasting levels of resources for immunisation against those strains of N. meningitis for which vaccines are available (currently A and C)
[serotypes Y and W-135 are included in combined vaccines -Mod. ES] are
illustrated by up to [20-fold differences] between thresholds for their use in different countries (1): 10 cases of group C disease in a population of 100,000 in a period of three months in the United States, compared with a weekly incidence of 15/100,000 in sub-Saharan Africa.
References:
1. Hubert B, Caugant DA. Recent changes in meningococcal disease in Europe.
Eurosurveillance 1997;2:69-71
2. Schuchat A, Robinson K, Wenger JD, Harrison LH, Farley M, Reingold AL,
et al. Bacterial meningitis in the United States in 1995. N Engl J Med
1997;337: 970-6
3. WHO. Meningitis in western Africa. Wkly Epidemiol Rec 1997; 72:115
Reported by Stuart Handysides (shandysi@phls.co.uk) PHLS Communicable
Disease Surveillance Centre, England.
--
Dorothy Preslar
ProMED-mail
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Regards,
Jack Simmons |
