Changes in Neisseria meningitidis Disease Epidemiology in the United States, 1998-2007: Implications for Prevention of Meningococcal Disease

被引:269
作者
Cohn, Amanda C. [1 ]
MacNeil, Jessica R. [1 ]
Harrison, Lee H. [5 ]
Hatcher, Cynthia [1 ]
Theodore, Jordan [1 ]
Schmidt, Mark [6 ]
Pondo, Tracy [1 ]
Arnold, Kathryn E. [2 ]
Baumbach, Joan [7 ]
Bennett, Nancy [8 ]
Craig, Allen S. [9 ]
Farley, Monica [3 ,4 ]
Gershman, Ken [11 ]
Petit, Susan [12 ]
Lynfield, Ruth [13 ]
Reingold, Arthur [14 ]
Schaffner, William [10 ]
Shutt, Kathleen A. [15 ]
Zell, Elizabeth R. [1 ]
Mayer, Leonard W. [1 ]
Clark, Thomas [1 ]
Stephens, David [2 ]
Messonnier, Nancy E. [1 ]
机构
[1] Ctr Dis Control & Prevent, Meningitis & Vaccine Preventable Dis Branch, Natl Ctr Immunizat & Resp Dis, Atlanta, GA 30333 USA
[2] Georgia Dept Human Resources, Div Publ Hlth, Atlanta, GA USA
[3] Emory Univ, Dept Med, Sch Med, Atlanta, GA 30322 USA
[4] Atlanta VA Med Ctr, Atlanta, GA USA
[5] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA
[6] Oregon Dept Human Serv, Portland, OR USA
[7] New Mexico Dept Hlth, Santa Fe, NM USA
[8] New York State Dept Hlth, Albany, NY 12237 USA
[9] Tennessee Dept Hlth, Nashville, TN USA
[10] Vanderbilt Univ, Sch Med, Dept Prevent Med, Nashville, TN 37212 USA
[11] Colorado Dept Publ Hlth & Environm, Denver, CO USA
[12] Connecticut Dept Publ Hlth, Hartford, CT USA
[13] Minnesota Dept Hlth, St Paul, MN USA
[14] Univ Calif Berkeley, Sch Publ Hlth, Berkeley, CA 94720 USA
[15] Univ Pittsburgh, Infect Dis Epidemiol, Res Unit, Pittsburgh, PA USA
关键词
NASOPHARYNGEAL CARRIAGE; IDENTIFICATION; VACCINE;
D O I
10.1086/649209
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. In January 2005, a quadrivalent (serogroups A, C, Y, and W-135) meningococcal conjugate vaccine was licensed for use in adolescents. This report describes the epidemiologic features of meningococcal disease in the United States from January 1998 through December 2007, before and during implementation of adolescent quadrivalent meningococcal conjugate vaccination. Methods. Data were collected from active surveillance for invasive Neisseria meningitidis conducted through the Active Bacterial Core surveillance (ABCs) sites during 1998-2007. Isolates from cases were serogrouped at the ABCs site and confirmed at the Centers for Disease Control and Prevention. Estimates of the incidence and number of cases in the 50 states were calculated, standardizing for race and age group. Results. In the period 1998-2007, a total of 2262 cases of meningococcal disease were reported from ABCs sites; 11.3% of these cases were fatal. The estimated United States average annual incidence of meningococcal disease was 0.53 cases per 100,000 population (95% confidence interval, 0.51-0.55), and an estimated 1525 ( 95% confidence interval, 1470-1598) cases occurred annually. The annual incidence decreased 64.1%, from 0.92 cases per 100,000 population in 1998 to 0.33 cases per 100,000 population in 2007. Infants aged ! 1 year have the highest incidence of meningococcal disease (5.38 cases per 100,000 population). After introduction of the quadrivalent meningococcal conjugate vaccine, no significant decrease in serogroup C or Y meningococcal disease was seen among those aged 11-19 years in 2006-2007, compared with 2004-2005. Conclusions. Before the introduction of the quadrivalent meningococcal conjugate vaccine, the incidence of meningococcal disease in the United States decreased to a historic low. However, meningococcal disease still causes a substantial burden of disease among all age groups. Future vaccination strategies may include targeting infants and preventing serogroup B meningococcal disease.
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收藏
页码:184 / 191
页数:8
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