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Outbreak of meningococcal disease in western Norway due to a new serogroup C variant of the ET-5 clone: effect of vaccination and selective carriage eradication

Published online by Cambridge University Press:  01 December 1999

I. SMITH ,
A. K. LEHMANN ,
L. LIE ,
A. DIGRANES ,
D. A. CAUGANT ,
E. A. HØIBY ,
L. O. FRØHOLM  and
A. HALSTENSEN
I. SMITH
Affiliation:
Institute of Medicine, University of Bergen, N-5021 Bergen, Norway
A. K. LEHMANN
Affiliation:
Institute of Medicine, University of Bergen, N-5021 Bergen, Norway
L. LIE
Affiliation:
Lindås Health Authority, N-5050 Lindås, Norway
A. DIGRANES
Affiliation:
Department of Microbiology and Immunology, The Gade Institute, Haukeland University Hospital, N-5021 Bergen, Norway
D. A. CAUGANT
Affiliation:
Department of Bacteriology, National Institute of Public Health, N-0403 Oslo, Norway
E. A. HØIBY
Affiliation:
Department of Bacteriology, National Institute of Public Health, N-0403 Oslo, Norway
L. O. FRØHOLM
Affiliation:
Department of Bacteriology, National Institute of Public Health, N-0403 Oslo, Norway
A. HALSTENSEN
Affiliation:
Institute of Medicine, University of Bergen, N-5021 Bergen, Norway
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Abstract

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A new sulphonamide resistant (SR) C[ratio ]15[ratio ]P1.7,16 meningococcal strain, a variant of the ET-5 clone, dominated in an outbreak of 22 cases in western Norway commencing in 1995. The first eight patients were 15–21 years old from the Nordhordland area, initiating a carrier study in the local high schools. Carriage of SR serogroup C meningococci was detected by routine methods and treated with a single dose of ofloxacin 400 mg. Of 20 treated carriers, 14 harboured the outbreak strain C[ratio ]15[ratio ]P1.7,16. Vaccination of 4000 children, adolescents and close contacts of patients was also performed. After the intervention, 14 additional cases of meningococcal disease occurred, 8 due to the outbreak strain. However, incidence rates dropped from 180 to 30 per 100000 per year in the student population, but increased from 0 to 13 in the rest of the population in Nordhordland. Carriage eradication is not generally recommended in Norway. However, tracing and treating meningococcal carriage may have reduced transmission and disease in this outbreak situation.

Type
Research Article
Information
Epidemiology & Infection , Volume 123 , Issue 3 , December 1999 , pp. 373 - 382
Copyright
© 1999 Cambridge University Press