ABCs Report: Neisseria meningitidis, 1997

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Active Bacterial Core Surveillance (ABCs): Emerging Infections Program Network

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ABCs Areas

California (3 county San Francisco Bay area); Connecticut; Georgia; Maryland; Minnesota; Oregon; Tennessee (5 urban counties)

ABCs Population

The surveillance areas represent 28,953,391 persons. Source: U.S. Bureau of the Census, 1997

ABCs Case Definition

Invasive meningococcal disease: isolation of Neisseria meningitidis from normally sterile site in a resident of a surveillance area in 1997.

ABCs Methodology

Project personnel communicated at least monthly with contacts in all microbiology laboratories serving acute care hospitals in their area to identify cases. Standardized case report forms that include information on demographic characteristics, clinical syndrome, and outcome of illness were completed for each identified case. Molecular subtyping was done on meningococcal isolates at CDC. Regular laboratory audits assess completeness of active surveillance and detect additional cases.

All rates of invasive meningococcal disease were calculated using U.S. Bureau of the Census postcensal population estimates for 1997.

Oregon has been experiencing a meningococcal outbreak with a site specific rate more than double the other surveillance sites. Thus, for national projections, race- and age-specific rates of disease were applied from the aggregate surveillance areas, excluding Oregon, to the race- and agespecific distribution of the 1997 U. S. population, excluding Oregon, and then the number of cases or deaths from Oregon were added.

Cases with unknown race were distributed by area based on reported race distribution for known cases within the eight age categories.

Reported ABCs Profiles

Race	No.	(Rate^*)
White	265	(1.2)
Black	95	(1.9)
Other	10	(0.7)
Total	370	(1.3)

Unknown race (n=31) distributed among knowns

^* Cases per 100,000 population for ABCs areas.

Syndrome	Cases No. (%^*)	Deaths No. (Rate^†)
Meningitis	172	(46.0)
Bacteremia without focus	147	(39.7)

^*Percent of cases.

^†Deaths per 100 cases.

Age (years)	B No. (Rate^*)	Serogroups C No. (Rate^*)	Serogroups Y No. (Rate^*)	Other No. (Rate^*)
<1	34 (8.5)	7 (1.8)	10 (2.5)	3 (0.8)
1	5 (1.3)	9 (2.3)	5 (1.3)	1 (0.2)
2-4	21 (1.7)	13 (1.1)	3 (0.2)	3 (0.2)
5-17	22 (0.4)	29 (0.5)	22 (0.4)	10 (0.2)
18-34	15 (0.2)	23 (0.3)	21 (0.3)	9 (0.1)
35-49	9 (0.1)	5 (0.1)	16 (0.1)	4 (0.1)
50-64	1 (0.03)	4 (0.1)	13 (0.2)	7 (0.2)
≥ 65	2 (0.1)	8 (0.2)	31 (0.7)	5 (0.1)
Total	109 (0.4)	98 (0.3)	121 (0.4)	42 (0.1)

^*Cases per 100,000 population for ABCs areas

Serogroup B Isolates Serosubtypes	Serogroup B Isolates No. (%)	Serogroup B Isolates Serotypes: Serosubtype	Serogroup B Isolates No. (%)
P1.7,16	46 (45)	15:P1.7,16	39 (37)
P1.14	8 (8)	4,7:P1.7,16	6 (6)
P1.7	7 (7)	15:P1,7	4 (4)
P1.19,15	5 (5)	10:P1.19,15	3 (3)
P1.4	5 (5)	4,7:P1.4	3 (3)
P1.5	4 (4)	4,7:P1.7	3 (3)
Of 59 isolates from Oregon, 39 (66%) were P1.7,16		Of 59 isolates from Oregon, 35 (59%) were 15:P1.7,16

National Projection for Invasive Disease

Cases: 2,800 (1.1/100,000)
Deaths: 300 (0.1/100,000)

Healthy People 2010 Update

Objective: Reduce the incidence of invasive meningococcal disease to 0.9 per 100,000 population.

Race	2010 Objective	1997 Rate^*
White	0.9/100,000	1.0
Black	0.9/100,000	1.8

^*Projected cases per 100,000 U.S. population.

Citation

Centers for Disease Control and Prevention. 1998. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Neisseria meningitidis, 1997.

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