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Harrison LH, Pass MA, Mendelsohn AB, et al. Invasive Meningococcal Disease in Adolescents and Young Adults. JAMA. 2001;286(6):694–699. doi:10.1001/jama.286.6.694
Author Affiliations: Department of International Health, Johns Hopkins University School of Hygiene and Public Health, Baltimore, Md (Dr Harrison and Mss Pass and Bustamante); Infectious Diseases Epidemiology Research Unit, University of Pittsburgh Graduate School of Public Health and School of Medicine (Drs Harrison and Egri) and Department of Epidemiology, University of Pittsburgh; Graduate School of Public Health (Dr Mendelsohn), Pittsburgh, Pa; Meningitis and Special Pathogens Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga (Dr Rosenstein); Laboratories Administration (Dr Razeq) and Epidemiology and Disease Control Program (Dr Roche), Maryland Department of Health and Mental Hygiene, Baltimore.Dr Egri is now with the Department of Public Health, Inonu University School of Medicine, Malatya, Turkey.
Context Incidence of invasive meningococcal disease has increased recently in
persons aged 15 through 24 years.
Objective To characterize meningococcal infection in adolescents and young adults
in Maryland during the 1990s.
Design and Setting Population-based surveillance study for meningococcal disease from January
1, 1990, through December 31, 1999, in Maryland.
Patients Maryland residents diagnosed as having invasive meningococcal disease.
Main Outcome Measure Invasive meningococcal infection.
Results Of 295 total cases, 71 (24.1%) occurred among persons aged 15 through
24 years. Sixteen (22.5%) of these cases were fatal. The annual incidence
rate increased from 0.9 to 2.1 cases per 100 000 among 15 through 24
year olds (P = .01). The proportion of all disease
increased from 16.0% to 28.9% (P = .03). The incidence
and proportion of cases subsequently decreased to 1.0 and 16.4% in 1998 through
1999, respectively. Infection in 15 through 24 year olds was more likely to
be fatal than infection in those younger than age 15 years (22.5% vs 4.6%; P = .001). Infection in 15 through 24 year olds, compared
with those aged 25 years or older, was more likely to be associated with male
sex (66.2% vs 34.8%; P<.001) and serogroup C infection
(46.9% vs 20.2%; P<.001), respectively. Infections
were potentially preventable with the licensed meningococcal vaccine in 82.8%
of 15 through 24 year olds, 68.1% of those younger than 15 years, and 76.8%
of adults aged 25 years or older.
Conclusions Incidence of meningococcal infection in 15 through 24 year olds in Maryland
increased and then declined during the 1990s. Infection in this age group
was associated with an unusually high case-fatality ratio, and the vast majority
of cases were potentially vaccine preventable.
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