Epidemiology and Infection

Original Papers

Invasive meningococcal disease in children in Jerusalem

C. STEIN-ZAMIRa1 c1, N. ABRAMSONa1, G. ZENTNERa1, H. SHOOBa1, L. VALINSKYa2 and C. BLOCKa3

a1 Jerusalem District Health Office, Ministry of Health, Israel

a2 Public Health Laboratories, Ministry of Health, Jerusalem, Israel

a3 Department of Clinical Microbiology & Infectious Diseases, Hadassah–Hebrew University Medical Centre, Jerusalem, Israel

Abstract

Neisseria meningitidis is an important cause of childhood meningitis and septicaemia. Between 1999 and 2005, 133 invasive meningococcal disease (IMD) cases occurred in Jerusalem, 112 (84·2%) of them in children aged 0–14 years. The annual incidence rate in Jerusalem was higher than the national average (2·45±0·6 vs. 1·13±0·16/100 000 population, P=0·002). Most of the children (82·1%) were from low socio-economic Arab and Jewish ultra-orthodox communities; mortality was higher among Arab than Jewish children (1·3 vs. 0·22/100 000 person-years, P=0·004). A cluster of 10 children with severe meningococcal sepsis (three fatalities) emerged in the winter of 2003–2004. Compared to the other 102 cases in 1999–2005 both meningococcaemia (100% vs. 51%, P=0·003) and mortality (30% vs. 6·9%, P=0·014) rates were higher. Serogroup B comprised 77·6% of the bacterial isolates. Pulsed-field gel electrophoresis showed considerable variability among cluster isolates, but significant resemblance in Arab cases throughout 1999–2005. The increased susceptibility of specific sub-populations to IMD necessitates further evaluation.

(Accepted June 27 2007)

(Online publication July 30 2007)

Correspondence:

c1 Author for correspondence: Dr C. Stein-Zamir, Jerusalem District Health Office, 86 Jaffa Road, Jerusalem 94341, Israel. (Email: chen@lbjer.health.gov.il)

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