Meningococcal Disease, 2012
Twelve cases of Neisseria meningitidis invasive disease (0.22 per 100,000 population) were reported in 2012, compared to 15 cases in 2011. There were 6 serogroup Y cases, 5 serogroup B, and 1 serogroup C. In addition, there were 3 suspect cases, all of which were fatalities including a case positive by PCR testing, and 2 cases positive from autopsy specimens that did not meet EIP inclusion criteria.
Cases ranged in age from 4 months to 73 years, with a mean of 36 years. Fifty percent of the cases occurred in the metropolitan area. Including multiple presentations in an individual case, 7 cases had meningitis, 4 had bacteremia without another focus of infection, 1 had septic arthritis, and 1 had otitis media. There was 1 fatality among confirmed cases in a 54 year old serogroup Y case. The 3 fatalities among suspect cases included a 25 year-old with serogroup B, and a 25 year-old and 86 year-old both with serogroup Y. All cases were sporadic with no epidemiologic links.
In 2012, 3 case isolates demonstrated intermediate resistance to penicillin and ampicillin. There were no 2012 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 2012, meningococcal conjugate vaccine MenHibrix®, covering serogroups Y and C and Haemophilus influenzae b, was extended for licensed use in the United States to 6 weeks 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 polysaccharideprotein conjugate vaccine for serogroups A,C,Y, and W-135 (MCV4). In 2011, the license was approved to include 9 through 23 months. 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. No cases qualified for enrollment in 2012.
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