ATLANTA--Although the incidence of sporadic outbreaks of bacterial meningitis in the United States has remained steady over the last three decades, a recent survey of bacterial meningitis cases in the metro Atlanta area and in Georgia has revealed a marked shift in the last eight years in both the age-specific incidence and in the specific subgroups of the disease. Results of the survey are being presented on March 10 at the International Conference on Emerging Infectious Diseases in Atlanta.
Emory University School of Medicine infectious diseases specialists David Stephens, M.D., and Monica Farley, M.D., led an eight-county metro-Atlanta survey of cases of meningitis caused by the bacterium Neisseria meningitidis between 1989 and 1996. The study was a collaboration between Emory and the Georgia Department of Human Resources as part of a Centers for Disease Control and Prevention sponsored Emerging Infection Program.
In Atlanta, 225 cases of invasive meningococcal disease occurred during the eight-year period. Although the number of cases per year remained fairly constant, the incidence of disease in adults over the age of 17 increased from 29% of cases in 1989 to 54% of cases in 1996. In contrast, the incidence in children less than four years old decreased from 61% of cases in 1989 to 46% of cases in 1996. Meningitidis serogroup Y was not detected in 1989-90, but in 1995-96 accounted for over 30% of cases. In 1995-96 72% of adult cases were due to serogroups C (44%) and Y (28%). Surveillance of meningitidis conducted statewide in 1997 revealed 73 cases, of which 63% were serogroup Y, 27% serogroup C, and 10% serogrouup B.
The researchers concluded that this shift in the age-specific and serogroup incidence of bacterial meningitis cases may indicate that a limited number of new, virulent clones of meningitidis are introduced and spread slowly in certain segments of the population. Detecting these changes may improve understanding of meningococcal outbreaks and the ability to prevent them.
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