To study changes in the epidemiology and management of meningococcal disease in one health district during a period of high local incidence of disease.
Prospective case ascertainment and data collection over 14 years, with retrospective analysis of cases.
West Gloucestershire (population 320 000).
Residents developing meningococcal disease between 1 january 1982 and 31 December 1995.
252 cases of invasive meningococcal disease were identified, of which 102 (40%) were officially notified and 191 (76%) were confirmed by culture from a deep site.
The observed disease incidence of 5.6/100 000/year was about 2.7 times the national incidence (as measured by either statutory notifications or reference laboratory reports).
The period 1983-90 was characterised by a prolonged localised outbreak due to serogroup B serotype 15 sulphonamide resistant (B15R) strains.
General practitioners gave benzylpenicillin before hospital admission to 18% of patients who presented with meningococcal disease in the first half of the study period and to 40% who presented in the second half.
The overall case fatality rate was 6.7% (17/252).
Four deaths were directly or indirectly related to lumbar puncture.
Of 120 patients whose lumbar puncture yielded meningococci, nine (8%) showed no abnormality on initial examination. (...)
Mots-clés Pascal : Méningococcie, Bactériose, Infection, Septicémie, Neisseria meningitidis, Neisseriaceae, Micrococcales, Bactérie, Méningite, Homme, Diagnostic, Epidémiologie, Incidence, Politique sanitaire, Benzylpénicilline, Traitement, Chimiothérapie, Pénicilline dérivé, Système nerveux pathologie, Système nerveux central pathologie
Mots-clés Pascal anglais : Meningococcal disease, Bacteriosis, Infection, Septicemia, Neisseria meningitidis, Neisseriaceae, Micrococcales, Bacteria, Meningitis, Human, Diagnosis, Epidemiology, Incidence, Health policy, Benzylpenicillin, Treatment, Chemotherapy, Penicillin derivatives, Nervous system diseases, Central nervous system disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0500702
Code Inist : 002B05B02I. Création : 13/02/1998.