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Diermayer M, Hedberg K, Hoesly F, et al. Epidemic Serogroup B Meningococcal Disease in Oregon: The Evolving Epidemiology of the ET-5 Strain. JAMA. 1999;281(16):1493–1497. doi:10.1001/jama.281.16.1493
Author Affiliations: Oregon Health Division, Portland (Drs Diermayer, Hedberg, Hoesly, and Fleming); the Division of Field Epidemiology, Epidemiology Program Office (Dr Diermayer), and the Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases (Drs Fischer, Perkins, and Reeves), Centers for Disease Control and Prevention, Atlanta, Ga.
Context In 1993, Oregon's incidence of serogroup B
meningococcal disease began to rise because of a highly clonal group of
strains designated enzyme type 5 (ET-5), the first such increase
observed in the United States.
Objective To evaluate the impact that the ET-5 strain has had on
the epidemiology of meningococcal disease in Oregon.
Design and Setting Epidemiologic analysis of surveillance data on
Oregon meningococcal disease cases from 1987 through 1996 and
multilocus enzyme electrophoresis typing of serogroup B isolates
from June 1993 through April 1995 and from April through June 1996.
Patients A total of 836 persons with invasive meningococcal
Main Outcome Measures Disease frequency and clonality of strains.
Results Serogroup B disease incidence rates more than doubled from
the preepidemic period in 1987-1992 (1.0 case per 100,000
population) to the recent epidemic period in 1995-1996 (2.2 cases per
100,000). The age-specific incidence rate of serogroup B disease
among those 15 through 19 years old increased 13-fold between the
preepidemic period (0.5 case per 100,000) and 1995-1996 (6.4
cases per 100,000). However, the proportion of cases with
meningococcemia and the case-fatality rate did not change. Of 99
Neisseria meningitidis isolates obtained from 1993-1995, 88
(89%) belonged to the ET-5 complex. Of these, 69 (78%) were a single
clone, designated 301. Of 20 serogroup B isolates from 1996, 18 (90%)
belonged to the ET-5 complex; 17 (94%) were the 301 clone.
Conclusion Serogroup B meningococcal disease incidence continues
at high levels in Oregon with increasing predominance of the ET-5
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