Meningococcal Disease, 2013

Twelve cases of Neisseria meningitidis invasive disease (0.2 per 100,000 population) were reported in 2013; 12 cases were also reported in 2012. There were 8 serogroup B, 3 serogroup C, and 1 serogroup Y case. All cases were sporadic except 2 serogroup B cases in central Minnesota linked through epidemiology and molecular sub typing. One meningococcemia case died.

Cases ranged in age from 15 days to 83 years, with a mean of 27 years. Fifty-eight percent of the cases occurred in the metropolitan area. Including multiple presentations in an individual case, 7 cases had meningitis, 4 had bacteremia without another focus of infection, 1 had pneumonia, and 1 had septic shock.

In 2013, 1 case isolate demonstrated intermediate resistance to penicillin. There were no 2013 case isolates with ciprofloxacin resistance. In 2008, 2 isolates from cases occurring in northwestern Minnesota had nalidixic acid MICs >8 µg/ml and ciprofloxacin MICs of 0.25 µg/ml indicative of resistance.

In 2012, meningococcal conjugate vaccine MenHibrix®, covering serogroups Y and C and Haemophilus influenzae b, was extended for licensed use in the United States to 6 weeks of age. Menactra® was licensed for use in the United States in January 2005 for persons aged 11 to 55 years, and was the first meningococcal polysaccharide-protein conjugate vaccine for serogroups A,C,Y, and W-135 (MCV4). In 2011, the license was approved to include 9 through 23 months. The U.S. Advisory Committee on Immunization Practices and American Academy of Pediatrics recommend immunization with either vaccine routinely at age 11-12 years or at high school entry and a booster dose at age 16, as well as for college freshmen living in dormitories, and other groups in the licensed age range previously determined to be at high risk. In 2006, MDH in collaboration with the CDC and other sites nationwide began a case-control study to examine the efficacy of MCV4; 1 case qualified for enrollment in 2013.

• For up to date information see>> Meningococcal Disease
• Full issue>> Annual Summary of Communicable Diseases Reported to the Minnesota Department of Health, 2013