Neisseria meningitidis Invasive Disease, 2003

Twenty-nine cases of Neisseria meningitidis invasive disease (0.6 per 100,000 population) were reported in 2003, compared to 36 cases in 2002. The distribution of serogroups among case isolates from 2003 was similar to 2002, except for a decline in the number of serogroup Y cases, with 16 (55%) serogroup C cases, eight (28%) serogroup B cases, three (10%) serogroup Y cases, one (3%) serogroup W-135 case, and one (3%) case whose isolate was not groupable.

Case-patients ranged in age from 1 month to 49 years, with a mean of 22 years. Sixty-six percent of the cases occurred in the Twin Cities metropolitan area. Seventeen (59%) case patients had meningitis, five (17%) had bacteremia without another focus of infection, two (7%) had bacteremia with pneumonia, two had peritonitis, one (3%) had septic arthritis, one had pericarditis, and one had cellulitis with bacteremia. All cases were sporadic, with no definite epidemiologic links.

Three deaths occurred among cases reported in 2003. A 19-year-old female and a 20-year-old female died of meningitis attributed to serogroup C. A 49-year-old male died of peritonitis due to serogroup Y.

Since the fall of 1998, MDH has collected additional information on college-aged students with N. meningitidis invasive disease as part of a nationwide effort to determine whether providing meningococcal vaccine to incoming college freshmen effectively prevents disease in this age group. In the fall of 1999, the Advisory Committee on Immunization Practices recommended that health care providers inform college students about meningococcal disease and the availability of vaccine. Serogroups A, C, Y, and W-135 are covered by the quadrivalent vaccine. Two serogroup C cases and one serogroup B case reported in Minnesota during 2003 occurred in college students; none were freshmen.

In the spring of 2002, MDH in collaboration with CDC and other EIP sites nationwide, began a case-control study of risk factors for meningococcal disease among high school students in Minnesota. One culture-confirmed serogroup B case and one confirmed serogroup C case occurred among high school students in 2003. One culture-negative suspected case of meningococcal disease, positive by polymerase chain reaction (PCR), occurred in a high school student also was included in the study in 2003.

• For up to date information see>> Meningococcal Disease
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2003