Meningococcal disease--New England, 1993-1998.

Neisseria meningitidis, a leading cause of bacterial meningitis and sepsis in children and young adults in the United States, causes both sporadic disease and outbreaks. Preventing and controlling meningococcal disease remains a public health challenge because of the multiple serogroups and the limitations of available vaccines. Vaccination with the polysaccharide meningococcal vaccine, which protects against serogroups A, C, Y, and W135 of N. meningitidis, is recommended by the Advisory Committee on Immunization Practices (ACIP) for controlling outbreaks but routine vaccination is not recommended for control of sporadic cases. During 1998, a cluster of meningococcal disease cases occurred in Rhode Island, and although the situation did not meet ACIP criteria for an outbreak, the Rhode Island Department of Health recommended vaccination of all residents aged 2-22 years. This action stimulated controversy in Rhode Island and the rest of New England (Connecticut, Maine, Massachusetts, New Hampshire, and Vermont) and prompted a review of the epidemiology of meningococcal disease in the region. This report describes meningococcal disease data reported to the region's state health departments during 1993-1998 and discusses the situation in Rhode Island.