TAILIEUCHUNG - Chapter 136. Meningococcal Infections (Part 2)

In the United States, the attack rate for sporadic meningococcal disease is ~1 case per 100,000 persons per year. Disease attack rates are highest among infants 3–9 months of age (10–15 cases per 100,000 infants per year). Attack rates are higher among children than among adults, and there is a second peak of incidence among teenagers, in whom outbreaks have often been tied to residence in barracks, dormitories, or other crowded conditions. This observation has prompted the recommendation that meningococcal polysaccharide-based vaccines (see below) be administered to incoming college freshmen to prevent outbreaks at colleges. Although the age-specific incidence. | Chapter 136. Meningococcal Infections Part 2 In the United States the attack rate for sporadic meningococcal disease is 1 case per 100 000 persons per year. Disease attack rates are highest among infants 3-9 months of age 10-15 cases per 100 000 infants per year . Attack rates are higher among children than among adults and there is a second peak of incidence among teenagers in whom outbreaks have often been tied to residence in barracks dormitories or other crowded conditions. This observation has prompted the recommendation that meningococcal polysaccharide-based vaccines see below be administered to incoming college freshmen to prevent outbreaks at colleges. Although the age-specific incidence is much lower among adults 1 case per 100 000 persons per year one-third to one-half of all cases of sporadic meningococcal disease occur in individuals 18 years of age. Peak disease incidence coincides with the winter peak of respiratory viral illnesses. During epidemics disease incidence increases disproportionately among teenagers and young adults. In sub-Saharan Africa epidemic outbreaks occur with the dry season and the coming of the dry dusty winds of the harmattan. Meningococcal disease occurs more commonly among the household contacts of primary cases than in the general population. The secondary attack rate is 400-1000 per 100 000 household members. School-based clusters of cases have also been described the attack rate among school contacts of cases has been estimated at 2-4 cases per 100 000 exposed individuals. In outbreaks on college campuses attack rates have been highest among students living in dormitories. Most secondary cases occur within 2 weeks of the primary case although some cases may develop as long as several months later. Secondary cases account for 2 of all cases reported each year in the United States. Meningococcal colonization of the nasopharynx asymptomatic carriage can persist for months. In nonepidemic periods 10 of healthy individuals are

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