home *** CD-ROM | disk | FTP | other *** search
- Document 0038
- DOCN M9620038
- TI Sporadic meningococcal disease in adults: results of a 5-year
- population-based study.
- DT 9602
- AU Stephens DS; Hajjeh RA; Baughman WS; Harvey RC; Wenger JD; Farley MM;
- Emory University School of Medicine, Veterans Affairs Medical; Center
- (Atlanta), Georgia, USA.
- SO Ann Intern Med. 1995 Dec 15;123(12):937-40. Unique Identifier : AIDSLINE
- MED/96072650
- AB OBJECTIVE: To define the incidence, demographics, clinical features, and
- risk factors for sporadic meningococcal disease in adults (> or = 18
- years) residing in metropolitan Atlanta. DESIGN: Prospective,
- population-based surveillance, with retrospective review of clinical and
- laboratory records. SETTING: Eight-county metropolitan Atlanta area.
- PATIENTS: All adult patients in whom Neisseria meningitidis was isolated
- from normally sterile sites (blood, cerebrospinal fluid) during the
- period 1 December 1988 to 30 November 1993. MEASUREMENTS: Incidence,
- relative risk, clinical and laboratory parameters, and serogroup of
- meningococcal isolates. RESULTS: For the 5-year period, 44 (33%) of 132
- cases of meningococcal disease in Atlanta occurred in adults (annual
- incidence, 0.50/100,000 adults per year). Twenty-three (52%) of the 44
- adults presented without rash or meningitis, the two most obvious signs
- of meningococcal disease. Pneumonia, sinusitis, or purulent
- tracheobronchitis, but without rash, were the likely sources of
- meningococcal bacteremia in 15 (34%) of the 44 adults. Twelve of the 15
- patients with meningococcal respiratory infection were older than 50
- years of age or were immunocompromised (or both), and three fourths of
- the 15 patients had disease caused by serogroups B, Y, and W-135.
- Overall, two thirds of adults older than 24 years of age with
- meningococcal disease had one or more immunocompromising conditions (for
- example, low complement 50 level [CH50], corticosteroid use, congestive
- heart failure, multiple myeloma, human immunodeficiency virus
- infection). Meningococcemia or meningococcal meningitis, often caused by
- serogroup C, were the presentations in 14 of 15 adults 18 to 24 years
- old; only 2 had an identified underlying condition. CONCLUSIONS: In this
- 5-year population-based study, one third of all cases of sporadic
- meningococcal disease occurred in adults. Over half of the adults
- presented without rash or meningitis. Pneumonia, sinusitis, and
- tracheobronchitis are important sources of bacteremic meningococcal
- disease, especially in immunocompromised patients and elderly persons.
- DE Adolescence Adult Bacteremia/EPIDEMIOLOGY/IMMUNOLOGY
- Georgia/EPIDEMIOLOGY Human Immunocompromised Host Incidence
- Meningococcal Infections/*EPIDEMIOLOGY/IMMUNOLOGY *Neisseria
- meningitidis Prospective Studies Retrospective Studies Risk Factors
- JOURNAL ARTICLE
-
- SOURCE: National Library of Medicine. NOTICE: This material may be
- protected by Copyright Law (Title 17, U.S.Code).
-
-