Epidemic Serogroup B Meningococcal Disease in Oregon

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Abstract
Epidemics of meningococcal disease have become uncommon in industrialized countries such as the United States, but the rapid and unexpected onset of the disease combined with high case-fatality rates make even endemic disease a significant public health concern. An estimated 2600 cases of endemic meningococcal disease, primarily meningitis and bacteremia, occur in the United States each year.1 The causative bacterium Neisseria meningitidis can be typed into more than 13 serogroups based on the polysaccharide capsule. In the United States, serogroups B and C each have accounted for approximately 45% of cases annually over the past several decades. Recently, however, outbreaks of serogroup C disease have been increasing in the United States and Canada, and a significant rise in serogroup Y cases has been noted in several areas of the United States.2-5 Historically, serogroup B disease tends to be sporadic, and when outbreaks do occur, attack rates are much lower (eg, 10 cases per 100,000 population) than those typically seen in developing countries where serogroup A epidemics predominate (>100 cases per 100,000 population).6