Raymond N J, Reeves M, Ajello G, Baughman W, Gheesling L L, Carlone G M, Wenger J D, Stephens D S
Emory University School of Medicine, Department of Veterans Affairs Medical Center, and Centers for Disease Control and Prevention, Atlanta, Georgia 30303, USA.
J Infect Dis. 1997 Nov;176(5):1277-84. doi: 10.1086/514123.
Understanding the basis of sporadic (endemic) meningococcal disease may be critical to prevention of meningococcal epidemic outbreaks and to understanding fluctuations in incidence. Active, prospective, population-based surveillance and molecular epidemiologic techniques were used to study sporadic serogroup C meningococcal disease in a population of 2.34 million persons (Atlanta area). During 1988-1994, in which no outbreaks or case clusters were reported, 71 patients developed sporadic serogroup C meningococcal disease (annual incidence, 0.51/100,000). Eighty-three percent of patients were >2 years old. By multilocus enzyme electrophoresis, pulsed-field gel electrophoresis, and serotyping, 84% (52/62) of the isolates available for study were identical or closely related members of the electrophoretic type 37 (ET 37) complex responsible for multiple serogroup C outbreaks in the United States in the 1990s. Sporadic disease caused by 9 clonal strains occurred over periods up to 4 years and accounted for 45% (28/62) of cases. Sporadic serogroup C meningococcal disease was most often due to a limited number of related strains that appear to slowly circulate in the population.
了解散发性（地方性）脑膜炎球菌病的发病基础对于预防脑膜炎球菌病的流行爆发以及理解发病率的波动情况可能至关重要。我们采用了主动、前瞻性、基于人群的监测方法和分子流行病学技术，对亚特兰大地区234万人口中的散发性C群脑膜炎球菌病进行了研究。在1988 - 1994年期间，该地区未报告有疫情爆发或病例聚集情况，共有71例患者患上散发性C群脑膜炎球菌病（年发病率为0.51/10万）。83%的患者年龄超过2岁。通过多位点酶电泳、脉冲场凝胶电泳和血清分型技术，在可供研究的分离株中，84%（52/62）是电泳型37（ET 37）复合体的相同或密切相关成员，该复合体在20世纪90年代曾在美国引发多次C群脑膜炎球菌病的爆发。由9种克隆菌株引起的散发性疾病在长达4年的时间里出现，占病例总数的45%（28/62）。散发性C群脑膜炎球菌病通常是由数量有限的相关菌株引起的，这些菌株似乎在人群中缓慢传播。
