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1996-02-26
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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).