       Document 0038
 DOCN  M9620038
 TI    Sporadic meningococcal disease in adults: results of a 5-year
       population-based study.
 DT    9602
 AU    Stephens DS; Hajjeh RA; Baughman WS; Harvey RC; Wenger JD; Farley MM;
       Emory University School of Medicine, Veterans Affairs Medical; Center
       (Atlanta), Georgia, USA.
 SO    Ann Intern Med. 1995 Dec 15;123(12):937-40. Unique Identifier : AIDSLINE
       MED/96072650
 AB    OBJECTIVE: To define the incidence, demographics, clinical features, and
       risk factors for sporadic meningococcal disease in adults (> or = 18
       years) residing in metropolitan Atlanta. DESIGN: Prospective,
       population-based surveillance, with retrospective review of clinical and
       laboratory records. SETTING: Eight-county metropolitan Atlanta area.
       PATIENTS: All adult patients in whom Neisseria meningitidis was isolated
       from normally sterile sites (blood, cerebrospinal fluid) during the
       period 1 December 1988 to 30 November 1993. MEASUREMENTS: Incidence,
       relative risk, clinical and laboratory parameters, and serogroup of
       meningococcal isolates. RESULTS: For the 5-year period, 44 (33%) of 132
       cases of meningococcal disease in Atlanta occurred in adults (annual
       incidence, 0.50/100,000 adults per year). Twenty-three (52%) of the 44
       adults presented without rash or meningitis, the two most obvious signs
       of meningococcal disease. Pneumonia, sinusitis, or purulent
       tracheobronchitis, but without rash, were the likely sources of
       meningococcal bacteremia in 15 (34%) of the 44 adults. Twelve of the 15
       patients with meningococcal respiratory infection were older than 50
       years of age or were immunocompromised (or both), and three fourths of
       the 15 patients had disease caused by serogroups B, Y, and W-135.
       Overall, two thirds of adults older than 24 years of age with
       meningococcal disease had one or more immunocompromising conditions (for
       example, low complement 50 level [CH50], corticosteroid use, congestive
       heart failure, multiple myeloma, human immunodeficiency virus
       infection). Meningococcemia or meningococcal meningitis, often caused by
       serogroup C, were the presentations in 14 of 15 adults 18 to 24 years
       old; only 2 had an identified underlying condition. CONCLUSIONS: In this
       5-year population-based study, one third of all cases of sporadic
       meningococcal disease occurred in adults. Over half of the adults
       presented without rash or meningitis. Pneumonia, sinusitis, and
       tracheobronchitis are important sources of bacteremic meningococcal
       disease, especially in immunocompromised patients and elderly persons.
 DE    Adolescence  Adult  Bacteremia/EPIDEMIOLOGY/IMMUNOLOGY
       Georgia/EPIDEMIOLOGY  Human  Immunocompromised Host  Incidence
       Meningococcal Infections/*EPIDEMIOLOGY/IMMUNOLOGY  *Neisseria
       meningitidis  Prospective Studies  Retrospective Studies  Risk Factors
       JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

