Round A, Evans M R, Salmon R L, Hosein I K, Mukerjee A K, Smith R W, Palmer S R
PHLS, Communicable Disease Surveillance Centre (Wales), Cardiff, UK.
Eur J Public Health. 2001 Dec;11(4):431-6. doi: 10.1093/eurpub/11.4.431.
Increasing numbers of outbreaks of Group C meningococcal disease in teenagers and young adults led to a new policy in the UK in 1999 of vaccinating all new college students. The largest of these outbreaks involved seven students in one university, six of whom were from one hall of residence, and two of whom died.
Control of the outbreak involved close medical surveillance of resident students, mass chemoprophylaxis and vaccination, and wide dissemination of daily information bulletins. Investigation of the epidemiology of the outbreak involved searching for the network of close contacts between cases, a prevalence survey of carriage of meningogocci and a case control study of risk factors for carriage.
Clinical cases could be linked by a discrete network of social contacts within the halls of residence, but the Group C epidemic strain (2a P1.5) was not detected in 454 students (upper 95% confidence interval 0.7%). Carriage of any meningococcal strain (19%) was associated with patronage of the campus bar (OR = 3.0, 0.99-9.1).
Important factors in the control of the outbreak were rapid institution of mass chemopropylaxis and immunisation of residents, and involvement of student organizations in the dissemination of information about the disease and its control. The role of campus bars in dissemination of the carriage of meningogocci deserves further investigation.
青少年和青年人群中C群脑膜炎球菌病暴发数量不断增加，促使英国于1999年出台一项新政策，即对所有新入学大学生进行疫苗接种。其中规模最大的一次暴发涉及一所大学的7名学生，其中6名来自同一宿舍，2人死亡。
控制此次暴发包括对住校学生进行密切医学监测、大规模化学预防和疫苗接种，以及广泛发布每日情况通报。对暴发的流行病学调查包括寻找病例之间的密切接触网络、脑膜炎球菌携带情况的患病率调查以及携带危险因素的病例对照研究。
临床病例可通过宿舍内一个离散的社会接触网络联系起来，但在454名学生中未检测到C群流行菌株（2a P1.5）（95%置信区间上限为0.7%）。携带任何脑膜炎球菌菌株（19%）与光顾校园酒吧有关（比值比=3.0，0.99 - 9.1）。
控制此次暴发的重要因素包括迅速开展大规模化学预防和对住校学生进行免疫接种，以及学生组织参与疾病及其控制信息的传播。校园酒吧在脑膜炎球菌携带传播中的作用值得进一步研究。
