Meningococcal Disease 2002

Table 1. Meningococcal Disease Cases by Race and Sex, Indiana, 2002

  2002 1998-2002
Cases Rate* Cases
Total 35 .57 259
Race
   White 27 .49 192
   Black 6 1.14 28
   Other 0   6
   Not Reported 2   33
Sex
   Male 21 .69 128
   Female 14 .44 131
   Not Reported 0    

*Rate per 100,000 population based on the U.S. Census Bureau’s population data as of July 1, 2002

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 2002, there were 35 confirmed cases of invasive meningococcal disease in Indiana and, of those, 2 resulted in death. The 35 reported cases in 2002 represented the lowest number of cases reported during the five-year period 1998-2002 (Figure 1).

Incidence of meningococcal disease usually climbs in early spring and late winter. Figure 2 indicates an increase of incidence in the late winter, early spring, and late summer. Cases of meningococcal disease tend to occur more frequently in infants, children, and young adults. In 2002, the infant case rate was 8.2/100,000 population (Figure 3).

Of the 20 counties reporting cases in 2002, the incidence rates were highest among the following counties reporting five or more cases: Allen (1.5), Lake (1.0), and Marion (0.9). Figure 4 shows counties reporting five or more cases.

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 identifies the serogroups in Indiana since 1998, when serogrouping first became available. A shift can be seen from 2000 to 2001 in serogroups C and Y to serogroup B. This shift was noticed once again in 2002.

Table 2. Meningococcal Disease Serotypes, Number and Percent of Isolates, Indiana, 1998-2002

Serogroup 1998 1999 2000 2001 2002
A 1(1.5%) -- -- --  
B 16(23.9%) 10(16.7%) 8(15.7%) 17(36.2%) 8(22.8%)
C 12(17.9%) 19(31.7%) 12(23.5%) 8(17.0%) 7(21.2%)
Y 15(22.4%) 8(13.3%) 12(23.5%) 12(25.5%) 9(27.7%)
W-135 1(1.5%) 2(3.3%) -- --  
Z -- -- -- 1(2.1%) 1(2.8%)
Not Groupable 3(4.5%) 3(5.0%) 2(3.9%) 1(2.1%) 4(11.4%)
Not Typed/Unknown 19(28.4%) 17(29%) 17(33.3%) 8(17.0%) 6(17.1%)
Total 67 59 51 47 35

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