Meningococcal Disease, 2011
Fifteen cases of Neisseria meningitidis invasive disease (0.28 per 100,000 population) were reported in 2011, compared to 9 cases in 2010. There were 8 serogroup B cases, 5 serogroup Y, and 1 serogroup W135, and 1 not groupable.
Cases ranged in age from 5 months to 98 years, with a median of 48 years. Sixty percent of the cases occurred in the metropolitan area. Eight cases had meningitis, 4 had bacteremia without another focus of infection, 2 had septic arthritis, and 1 had pneumonia. There were no fatalities. All cases were sporadic with no epidemiologic links. In 2011, 1 case-isolate demonstrated intermediate resistance to penicillin and ampicillin, as well as resistance to trimethoprim/sulfamethoxazole. One additional case-isolate demonstrated intermediate resistance to penicillin. Seven additional case isolates demonstrated resistance to trimethoprim/sulfamethoxazole. There were no 2011 case-isolates with ciprofloxacin resistance. In 2008, 2 isolates from cases occurring in northwestern Minnesota had nalidixic acid MICs >8 μg/ml and ciprofloxacin MICs of 0.25 μg/ml indicative of resistance.
In 2011, meningococcal conjugate vaccine (Menveo), previously licensed for 11-15 year-olds in 2010, was extended for licensed use in the United States to 9 months of age. Menactra was licensed for use in the United States in January 2005 for persons aged 11 to 55 years, and was the first meningococcal polysaccharide-protein conjugate vaccine for serogroups A,C,Y, and W-135 (MCV4). In 2007, the license was approved to include 2 to 10 year-olds. The U.S. Advisory Committee on Immunization Practices and American Academy of Pediatrics recommend immunization with either vaccine routinely at age 11-12 years or at high school entry and a booster dose at age 16, as well as for college freshmen living in dormitories, and other groups in the licensed age range previously determined to be at high risk. In 2006, MDH in collaboration with the CDC and other sites nationwide, began a case-control study to examine the efficacy of MCV4 and the study continues.
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