Ward J, Hanna J N, Bates J R, Selvey L A
Specialised Health Services (Queensland TB Control Centre), Locked Bag 66, Coorparoo, Qld Australia 4152.
Commun Dis Intell. 2000 Nov;24(11):332-5. doi: 10.33321/cdi.2000.24.57.
Enhanced surveillance of invasive meningococcal disease commenced in Queensland in 1999. There were 93 cases, an incidence of 2.8/100,000 population. Most (87%) cases were laboratory confirmed, but 12 per cent were probable cases without laboratory confirmation. The highest age-specific attack rates were in the under 1, 1 to 4 and 15 to 24 year age groups. Most of the serologically characterised isolates were group B (70%), followed by group C (24%). There were 12 deaths, resulting in a case fatality rate of 13 per cent. Those who died were more likely to have group C than group B disease (OR 5.04, CI 1.05-25.14). Only 14 per cent of cases that saw a general practitioner (GP) prior to hospitalization received parenteral antibiotics, 23 per cent of the 35 cases referred to hospital by a GP received pre-hospital parenteral antibiotics and 33 per cent of cases were notified to health authorities within 24 hours of hospital admission. Thirty per cent were notified two or more days after hospitalization, delaying the start of public health action. Enhanced surveillance has demonstrated a need to promote the use of pre-hospital parenteral antibiotics by GPs and a need to encourage more timely reporting of cases to health authorities.
1999年昆士兰州开始加强对侵袭性脑膜炎球菌病的监测。共报告93例病例，发病率为2.8/10万人口。大部分病例（87%）经实验室确诊，但12%为未经实验室确诊的疑似病例。年龄组发病率最高的是1岁以下、1至4岁和15至24岁年龄组。大多数经血清学鉴定的分离株为B群（70%），其次是C群（24%）。有12例死亡，病死率为13%。死亡病例中感染C群疾病的可能性高于B群（比值比5.04，可信区间1.05 - 25.14）。只有14%的病例在住院前看过全科医生（GP）并接受了胃肠外抗生素治疗，35例由全科医生转诊至医院的病例中有23%在院前接受了胃肠外抗生素治疗，33%的病例在入院后24小时内报告给了卫生当局。30%的病例在住院两天或更长时间后才报告，从而延误了公共卫生行动的启动。加强监测表明，需要促进全科医生使用院前胃肠外抗生素，并鼓励更及时地向卫生当局报告病例。
