Epidemiology and Infection
- Epidemiology and Infection / Volume 140 / Issue 05 / May 2012, pp 906-915
- Copyright © Cambridge University Press 2011
- DOI: http://dx.doi.org/10.1017/S0950268811001610 (About DOI), Published online: 30 August 2011
Meningococcal infection
Outbreak of Neisseria meningitidis C in workers at a large food-processing plant in Brazil: challenges of controlling disease spread to the larger community
B. P. M. ISERa1 c1, H. C. A. V. LIMAa1, C. De MORAESa1a2, R. P. A. De ALMEIDAa3, L. T. WATANABEa3, S. L. A. ALVESa4, A. P. S. LEMOSa5, M. C. O. GORLAa5, M. G. GONÇALVESa6, D. A. DOS SANTOSa1 and J. SOBELa1a7
a1 Field Epidemiology Training Program (FETP), Centre for Strategic Information in Health Surveillance (CIEVS), Secretariat of Health Surveillance, Ministry of Health, Brazil
a2 Vaccine Preventable Disease Branch, Secretariat of Health Surveillance, Ministry of Health, Brazil
a3 State Health Secretariat, Goias State, Brazil
a4 Public Health Laboratory Central, Goias State, Brazil
a5 Division of Medical Biology, Bacteriology Department, Adolfo Lutz Institute, São Paulo, Brazil
a6 Division of Medical Biology, Immunology Department, Adolfo Lutz Institute, São Paulo, Brazil
a7 Centers for Diseases Control and Prevention (CDC), Atlanta, GA USA
SUMMARY
An outbreak of meningococcal disease (MD) with severe morbidity and mortality was investigated in midwestern Brazil in order to identify control measures. A MD case was defined as isolation of Neisseria meningitidis, or detection of polysaccharide antigen in a sterile site, or presence of clinical purpura fulminans, or an epidemiological link with a laboratory-confirmed case-patient, between June and August 2008. In 8 out of 16 MD cases studied, serogroup C ST103 complex was identified. Five (31%) cases had neurological findings and five (31%) died. The attack rate was 12 cases/100 000 town residents and 60 cases/100 000 employees in a large local food-processing plant. We conducted a matched case-control study of eight primary laboratory-confirmed cases (1:4). Factors associated with illness in single variable analysis were work at the processing plant [matched odds ratio (mOR) 22, 95% confidence interval (CI) 2·3–207·7, P<0·01], and residing <1 year in Rio Verde (mOR 7, 95% CI 1·11–43·9, P<0·02). Mass vaccination (>10 000 plant employees) stopped propagation in the plant, but not in the larger community.
(Accepted August 01 2011)
(Online publication August 30 2011)
Correspondence:
c1 Author for correspondence: Mrs B. P. M. Iser, Coordenação Geral de Doenças e Agravos não-transmissíveis – CGDANT, Secretaria de Vigilância em Saúde, Ministério da Saúde – SVS/MS, SAF Sul, Trechos 02 – Lotes 05/06 – Bloco F – Torre 1. Edificio Premium – Térreo, Sala 14, CEP 70070-600. (Email: betine.iser@saude.gov.br)
