Agence de Médecine Préventive, Paris, France.
J Infect Dis. 2011 Dec 1;204(11):1787-95. doi: 10.1093/infdis/jir623. Epub 2011 Oct 12.
To better understand localized meningococcal meningitis epidemics, we evaluated a serogroup A (NmA) epidemic in Burkina Faso by surveillance, carriage, and seroprevalence studies.
During March-April 2006, cerebrospinal fluid samples from patients suspected to have meningitis in 3 epidemic villages were analyzed by culture or polymerase chain reaction. We assessed meningococcal carriage and serogroup-specific serum bactericidal antibody titers with baby rabbit complement (rSBA) in a representative population sample (N = 624; age range, 1-39 years). A serogroup A/C polysaccharide vaccine campaign occurred in parallel.
Cumulative incidence of Nm meningitis was 0.45% and varied among villages (0.08%-0.91%). NmA carriage prevalence was 16% without variation by vaccination status. NmA carriage and anti-NmA seroprevalence varied by village and incidence. In the 2 villages with highest incidence and seroprevalence, presence of rSBA titers ≥8 was associated with NmA carriage (odds ratio [OR], 9.33 [95% confidence interval {CI}, 1.90-45.91]) and vaccination ≤4 days earlier (OR, 0.10 [95% CI, .03-.32]). Visibly purulent or Nm meningitis was significantly associated with recent flulike symptoms and exposure to kitchen smoke (risk ratios >15).
A surge of NmA carriage may be involved in the development of meningococcal epidemics and rapidly increase anti-NmA seroprevalence. Flulike infection and kitchen smoke may contribute to the strength of epidemics.
为了更好地了解地方性脑膜炎奈瑟菌（Nm）脑膜炎流行情况，我们通过监测、带菌情况和血清流行率研究，对布基纳法索的 A 群（NmA）流行动态进行了评估。
2006 年 3 月至 4 月期间，对 3 个流行村疑似脑膜炎患者的脑脊液样本进行了培养或聚合酶链反应分析。我们采用婴儿兔补体（rSBA）对具有代表性的人群样本（N=624；年龄范围为 1-39 岁）进行了脑膜炎奈瑟菌带菌情况和血清杀菌抗体滴度（针对各血清群的特异性）的评估。同时开展了 A/C 群多糖疫苗接种活动。
Nm 脑膜炎的累计发病率为 0.45%，且各村庄之间存在差异（0.08%-0.91%）。未发现疫苗接种状况与 NmA 带菌率之间存在差异，其带菌率为 16%。NmA 带菌情况和抗 NmA 血清流行率因村庄和发病率而异。在发病率和血清流行率最高的 2 个村庄，rSBA 滴度≥8 与 NmA 带菌（比值比[OR]，9.33[95%置信区间{CI}，1.90-45.91]）和 4 天内最近接种疫苗（OR，0.10[95%CI，.03-.32]）有关。有明显脓性分泌物或 Nm 脑膜炎与近期流感样症状和接触厨房烟雾显著相关（风险比>15）。
NmA 带菌量的增加可能与脑膜炎奈瑟菌流行的发生有关，并可迅速提高抗 NmA 血清流行率。流感样感染和厨房烟雾可能有助于流行的发展。
