Epidemiology and Infection

A cluster of meningococcal disease in western Sydney, Australia initially associated with a nightclub

J. JELFS a1c1, B. JALALUDIN a2, R. MUNRO a1, M. PATEL a3, M. KERR a2, D. DALEY a1, S. NEVILLE a1 and A. CAPON a2
a1 Department of Microbiology and Infectious Diseases, South Western Area Pathology Service, Liverpool, NSW 2170, Australia
a2 Western Sector Public Health Unit, North Parramatta, Sydney, NSW 2151, Australia
a3 National Centre for Epidemiology and Population Health, The Australian National University, Canberra ACT 0200, Australia


Fourteen cases of meningococcal disease (MD) occurred in August–September 1996 in western Sydney, Australia. Seven of the 10 young adults affected had a direct or indirect link with a local nightclub. Ten of 11 systemic meningococcal isolates had the phenotype C[ratio]2a[ratio]P1.5 and showed close genetic relationship by pulsed-fleld gel electrophoresis (PFGE). Organisms of this phenotype have not previously caused outbreaks in Australia, but have been associated with outbreaks and hyperendemic serogroup C MD in Europe, Canada, and the United States.

This is the largest cluster of serogroup C MD reported in urban Australia, and the first involving a nightclub. The strain differentiation results were available rapidly enough to augment epidemiological investigations on a daily basis. Public health staff could thus establish links between cases quickly, follow the spread of new cases in the community, give accurate information to health officials and the press, and utilize existing knowledge about the characteristics of this phenotype to predict likely developments during the outbreak and afterwards. The strain differentiation data was also very helpful when the role of vaccination was considered, and existing guidelines on the management of outbreaks of MD could be used effectively for the first time in western Sydney.

(Accepted January 22 1998)

c1 Author for correspondence: Department of Microbiology and Infectious Diseases, S.W.A.P.S., Locked Mail Bag 90, Liverpool, NSW 2170, Australia.