Grotto I, Block C, Lerman Y, Wiener M, Ashkenazi S
Medical Corps, Israel Defense Force, Tel-Hashomer.
Isr J Med Sci. 1995 Jan;31(1):54-8.
To determine recent trends in its epidemiology and the need to reconsider prophylactic interventions, meningococcal disease in the Israel Defense Force (IDF) from 1975 through 1993 was studied. All cases of meningitis or meningococcemia were included. A considerable increase in the number of cases has been observed since 1991, with serogroup C becoming predominant (76% of cases) since then. Serogroup Y was the second most frequent serogroup during this period, while serogroup B, predominant in the civilian population of Israel, was rare. Most cases occurred during the first 6 months of military service. Seasonality was important, with most of the cases occurring between December and March, although a small summer peak was also noted. Since 1992, three small clusters of meningococcal disease were encountered in the IDF, for the first time, with all cases caused by group C meningococci. In one cluster, the emergence of rifampicin resistance resulted in failure of chemoprophylaxis. The rise in group C and Y cases since 1991, and the occurrence of rifampicin resistance, necessitate considering meningococcal vaccines and new antimicrobial agents for prophylaxis.
为了确定其流行病学的近期趋势以及重新考虑预防性干预措施的必要性，对1975年至1993年以色列国防军（IDF）中的脑膜炎球菌病进行了研究。纳入了所有脑膜炎或脑膜炎球菌血症病例。自1991年以来观察到病例数量大幅增加，此后C群成为主要菌群（占病例的76%）。在此期间，Y群是第二常见的菌群，而在以色列平民中占主导地位的B群则很少见。大多数病例发生在服役的前6个月。季节性很重要，大多数病例发生在12月至3月之间，不过也注意到一个小的夏季高峰。自1992年以来，IDF首次出现了三起小规模的脑膜炎球菌病聚集性病例，所有病例均由C群脑膜炎球菌引起。在一次聚集性病例中，利福平耐药性的出现导致化学预防失败。1991年以来C群和Y群病例的增加以及利福平耐药性的出现，有必要考虑使用脑膜炎球菌疫苗和新的抗菌药物进行预防。
