To ALL...here is a UK Survey. It may be more of just an interest..a Challenge? Copy below:
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MENINGOCOCCAL DISEASE - UK: RETROSPECTIVE SURVEY
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A ProMED-mail post
[see also:
Meningitis - England & Wales 970407200456
Meningococcal community outbreak - England (Derbys... 970314150817
Meningococcal meningitis - UK (England) 971112090416]
Date: Thu, 25 Dec 1997 10:43:03 -0800
From: Dr. James Chin, CDPC-mail
Source: CDR Review (UK) - Vol. 7 / No. 13
A retrospective survey of clusters of meningococcal disease in England and
Wales, 1993 to 1995: estimated risks of further cases in household and
educational settings - L Hastings, J Stuart, N Andrews, N Begg
Summary: Information about the epidemiology of meningococcal disease case
clusters and the risk of further cases is sparse. Data on clusters in
household and educational settings from 1 January 1993 to 31 March 1995 was
requested from consultants in communicable disease control in England and
Wales through a retrospective postal survey. Ninety-three per cent (122/131)
responded. Of the 114 cases in 45 reported clusters, 77 (67.5%) were
microbiologically confirmed. The case fatality rate in index cases was
higher than in associated cases (18.2% vs 4.5%; p=0.02). Five out of 11
clusters in household settings consisted only of index and co-primary cases.
No further cases occurred within two weeks after giving chemoprophylaxis to
household contacts. The relative risks of further cases in the week after
the index case arose were estimated to be 1200 for contacts in the
household, 160 in secondary schools, 60 in primary schools, 1.8 in
universities/colleges, and 0 in nurseries. Between seven and 30 days the
relative risks were lower; 150 in households, and between 0 and 13 in all
other settings. Beyond 30 days, the relative risk in the household setting
was 8 and lower than this in all other settings. The absolute risk of
further cases in the month following the index case was calculated as 210
per 100000 in household members, 7-10/10 5 in pupils at the same school, and
0.6/10 5 in students at the same university or college. The current policy
in England and Wales to recommend chemoprophylaxis for household members may
prevent half of the further cases in this setting. Raised awareness may have
contributed to the lower case fatality rate among household contacts who
developed meningococcal disease, but the number of co-primary cases observed
should prompt urgent enquiries about current illness in household contacts
of index cases. The relative risk of further cases in preschool groups was
low and apparently unaffected by changes in chemoprophylactic policy. The
relative risk in school settings was raised in the month following a case,
but the absolute risk was still low. Further study to quantify the risk in
university settings is needed.
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