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The comments of Dr Brawley are much appreciated. Since the prevalence of this serogroup has increased during the past five years, the total number of reported cases will also increase and may well equal the prevalence of groups B and C disease. The association of serogroup W135 and pyogenic arthritis and systemic lupus erythematosus is of interest and needs confirmation when a larger population base is observed. It would be of interest in light of the possible lack of association of serogroup W135 and skin lesions to test this observation in experimental animals susceptible to the localized Shwartzman reaction following parenteral administration of endotoxin.
Roberts RB. Neisseria meningitidis Serogroup W135 Disease-Reply. JAMA. 1982;247(20):2779. doi:10.1001/jama.1982.03320450017012