Rosenstein N E, Perkins B A, Stephens D S, Lefkowitz L, Cartter M L, Danila R, Cieslak P, Shutt K A, Popovic T, Schuchat A, Harrison L H, Reingold A L
Division of Bacterial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Infect Dis. 1999 Dec;180(6):1894-901. doi: 10.1086/315158.
New meningococcal vaccines are undergoing clinical trials, and changes in the epidemiologic features of meningococcal disease will affect their use. Active laboratory-based, population-based US surveillance for meningococcal disease during 1992-1996 was used to project that 2400 cases of meningococcal disease occurred annually. Incidence was highest in infants; however, 32% of cases occurred in persons >/=30 years of age. Serogroup C caused 35% of cases; serogroup B, 32%; and serogroup Y, 26%. Increasing age (relative risk [RR], 1.01 per year), having an isolate obtained from blood (RR, 4.5), and serogroup C (RR, 1.6) were associated with increased case fatality. Among serogroup B isolates, the most commonly expressed serosubtype was P1.15; 68% of isolates expressed 1 of the 6 most common serosubtypes. Compared with cases occurring in previous years, recent cases are more likely to be caused by serogroup Y and to occur among older age groups. Ongoing surveillance is necessary to determine the stability of serogroup and serosubtype distribution.
新型脑膜炎球菌疫苗正在进行临床试验，脑膜炎球菌病流行病学特征的变化将影响其使用。利用1992 - 1996年美国基于实验室主动监测和人群监测的数据预测，每年发生2400例脑膜炎球菌病。发病率在婴儿中最高；然而，32%的病例发生在30岁及以上人群中。C群导致35%的病例；B群，32%；Y群，26%。年龄增长（相对危险度[RR]，每年1.01）、分离株来自血液（RR，4.5）和C群（RR，1.6）与病死率增加相关。在B群分离株中，最常见的血清亚型是P1.15；68%的分离株表达6种最常见血清亚型中的1种。与往年发生的病例相比，近期病例更可能由Y群引起，且发生在年龄较大的人群中。持续监测对于确定菌群和血清亚型分布的稳定性是必要的。
