We appreciate the comments of Dr Press, whose experience with the treatment of children with occult meningococcal disease seems to be consistent with the data we presented. We gathered our data from 7 academic institutions during variable periods. Our estimate of the prevalence of unsuspected meningococcal disease per emergency department visit during these periods was 58 cases per approximately 2 million visits (or 1 case per approximately 34 000 visits). This is likely an overestimation, however, because some patients were referred to our institutions after complications had developed at outlying medical centers where the patients initially had unsuspected meningococcal disease.
Wang V, Malley R, Fleisher G, Inkelis S, Kupperman N. Incidence of Unsuspected Meningococcal Disease—Reply. Arch Pediatr Adolesc Med. 2001;155(6):741. doi:10.1001/archpedi.155.6.739