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BMC Infect Dis ; 12: 205, 2012 Sep 04.
Article in English | MEDLINE | ID: mdl-22943188

ABSTRACT

BACKGROUND: Neisseria meningitidis serogroup C has emerged as a cause of epidemic disease in Hefei. The establishment of serogroup C as the predominant cause of endemic disease has not been described. METHODS: We conducted national laboratory-based surveillance for invasive meningococcal disease during 2000-2010. Isolates were characterized by pulsed-field gel electrophoresis and multilocus sequence typing. RESULTS: A total of 845 cases of invasive meningococcal disease were reported. The incidence increased from 1.25 cases per 100,000 population in 2000 to 3.14 cases per 100,000 in 2003 (p < 0.001), and peaked at 8.43 cases per 100,000 in 2005. The increase was mainly the result of an increase in the incidence of serogroup C disease. Serogroup C disease increased from 2/23 (9%) meningococcal cases and 0.11 cases per 100,000 in 2000 to 33/58 (57%) cases and 1.76 cases per 100,000 in 2003 (p < 0.01). Patients infected with serogroup C had serious complications more frequently than those infected with other serogroups. Specifically, 161/493 (32.7%) cases infected with serogroup C had at least one complication. The case-fatality rate of serogroup C meningitis was 11.4%, significantly higher than for serogroup A meningitis (5.3%, p = 0.021). Among patients with meningococcal disease, factors associated with death in univariate analysis were age of 15-24 years, infection with serogroup C, and meningococcemia. CONCLUSIONS: The incidence of meningococcal disease has substantially increased and serogroup C has become endemic in Hefei. The serogroup C strain has caused more severe disease than the previously predominant serogroup A strain.


Subject(s)
Meningitis, Meningococcal/epidemiology , Meningitis, Meningococcal/mortality , Neisseria meningitidis, Serogroup C/classification , Neisseria meningitidis, Serogroup C/isolation & purification , Adolescent , Adult , Aged , Child , Child, Preschool , China/epidemiology , Cluster Analysis , Electrophoresis, Gel, Pulsed-Field , Endemic Diseases , Female , Genotype , Humans , Incidence , Infant , Male , Meningitis, Meningococcal/microbiology , Middle Aged , Molecular Epidemiology , Multilocus Sequence Typing , Neisseria meningitidis, Serogroup C/genetics , Survival Analysis , Young Adult
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