Meningococcal Disease 2003

Table 1. Meningococcal Disease Cases by Race and Sex, Indiana, 2003

  2003 1999-2003
Cases Rate* Cases
Total 49 0.80 241
Race
   White 38 0.70 181
   Black 5 0.90 24
   Other 1 0.60 4
   Not Reported 5 - 32
Sex
   Male 25 0.80 125
   Female 24 0.80 116
   Not Reported 0 -  

*Rate per 100,000 population based on the U.S. Census Bureau’s population data as of July 1, 2003

Meningococcal infection most commonly manifests as meningitis or meningococcemia. It is transmitted person to person via respiratory droplets from the nose and throat secretions of a person infected with Neisseria meningitidis. Up to 10 percent of United States residents may be colonized with N. meningitidis in the nasopharynx and have no symptoms of illness.

In 2003, there were 49 confirmed cases of invasive meningococcal disease in Indiana and, of those, 5 resulted in death. Figure 1 shows the number of reported cases for the five-year period 1999-2003.

Incidence of meningococcal disease usually climbs in early spring and late winter. Figure 2 indicates an increase of incidence in the winter, spring, and late summer. Cases of meningococcal disease tend to occur more frequently in infants, children, and young adults. In 2003, infants less than 1 year of age (12) had the highest case rate, followed by preschoolers aged 1-4 years (2.0) (Figure 3).

Of the 29 counties reporting cases in 2003, only two counties reported 5 or more cases (adjusted for population): Allen (2.1) and Marion (0.92).

Serogroups A, B, C, Y, and W-135 are most frequently associated with invasive disease in the United States. As of October 2000, laboratories are required to submit N. meningitidis isolates from normally sterile sites to the Indiana State Department of Health (ISDH) Laboratories for serogrouping. Additionally, molecular subtyping can be performed by pulse-field gel electrophoresis (PFGE) on selected meningococcal isolates that may indicate a cluster of cases. Serogroup B currently accounts for approximately 45 percent of meningococcal isolates confirmed in the ISDH Laboratory (Table 2).

 

Table 2. Meningococcal Disease Serotypes, Number and Percent of Isolates, Indiana, 1999-2003

Serogroup 1999 2000 2001 2002 2003
A -- -- -- -- --
B 10(16.7%) 8(15.7%) 17(36.2%) 8(22.8%) 22(44.8%)
C 19(31.7%) 12(23.5%) 8(17.0%) 7(21.2%) 6(12.2%)
Y 8(13.3%) 12(23.5%) 12(25.5%) 9(27.7%) 10(20.4%)
W-135 2(3.3%) -- -- -- --
Z -- -- 1(2.1%) 1(2.8%) --
Not Groupable 3(5.0%) 2(3.9%) 1(2.1%) 4(11.4%) 2(4.1%)
Not Typed/Unknown 17(29%) 17(33.3%) 8(17.0%) 6(17.1%) 9(18.3%)
Total 59 51 47 35 49

Note: The 1998 and 1999 case totals and serotype breakdowns are corrected from the 1999 Report of Diseases of Public Health Interest.

Measures that would decrease the likelihood of transmission of the disease include:

  • Practicing good hand washing
  • Avoiding the sharing of beverage containers, cigarettes, lipstick, or eating utensils
  • Avoiding smoking and smoky environments
  • Getting plenty of sleep and exercising regularly
  • Eating a balanced diet and avoiding excessive alcohol consumption
  • Consulting a health care provider about available vaccines

You can learn more about meningococcal disease by visiting the following website:
http://www.in.gov/isdh/25455.htm