A 10-year serogroup B meningococcal disease epidemic in New Zealand: descriptive epidemiology, 1991-2000.
A 10-year serogroup B meningococcal disease epidemic in New Zealand: descriptive epidemiology, 1991-2000.
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DOI：
10.1046/j.1440-1754.2001.00722.x
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发表时间：
2001-10-01
影响因子：
1.7
通讯作者：
Lennon, D
中科院分区：
文献类型：
--
作者：
Baker, M G;Martin, D R;Lennon, D
目的：自1991年以来，新西兰经历了脑膜炎球菌病的流行。本文描述了该流行病头10年（1991-2000年）的特点、目前的控制措施和未来可能的干预措施。方法：新西兰脑膜炎球菌病监测采用通报和实验室数据相结合的方法。1991年和1996年的人口普查数据被用来计算发病率。结果：脑膜炎球菌病的年发病率从流行前的1990年的53例（1.6 / 10万人）上升到1997年的峰值613例（16.9 / 10万人），此后发病率持续上升。1996-2000年期间，每年平均发生502例（每10万人13.9例）。自1991年以来，该流行病已造成3547例病例，比根据流行前疾病发病率预计的数字多出约3000例。在全部病例中，158例（4.5%）死亡。在新西兰北岛北部的毛利人和太平洋岛屿儿童中有不成比例的大量病例。自1991年以来，该流行病越来越多地以P1.7b，4亚型血清B群脑膜炎球菌为主，到2000年占进行这种检测的所有病例的84.6%。这些生物的大部分特征为B:4:P1.7b,4。结论：在新西兰，脑膜炎球菌病的发病率很可能在未来几年内保持高水平。一种能够诱导对P1.7b，4 PorA亚型产生免疫的疫苗可能在控制该流行病中发挥作用。目前正在努力获得和试验这种疫苗。目前还在采取措施，减少造成这一流行病的过度拥挤的生活条件。病例的早期识别和抗生素治疗可改善预后，应继续推广。对脑膜炎球菌病的综合通报和基于实验室的监测在新西兰提供了对这种疾病的相对完整的监测，并支持了公共卫生干预措施的发展。
OBJECTIVE: New Zealand has experienced an epidemic of meningococcal disease since 1991. This paper describes the characteristics of this epidemic during its first 10 years (1991-2000), current control measures, and potential future interventions.METHODOLOGY: Meningococcal disease surveillance in New Zealand uses combined notification and laboratory data. Population census data from 1991 and 1996 were used to calculate disease rates.RESULTS: The annual incidence of meningococcal disease increased from 53 cases (1.6 per 100 000 population) in the pre-epidemic year of 1990 to a peak of 613 (16.9 per 100000) in 1997, followed by consistently raised rates. Over the 1996-2000 period, there was an average of 502 cases per year (13.9 per 100 000). The epidemic has resulted in 3547 cases since 1991 approximately 3000 in excess of the number expected based on pre-epidemic disease incidence. Of the total cases, 158 (4.5%) were fatal. A disproportionately large number of cases have been in Maori and Pacific Islands children in the northern part of the North Island of New Zealand. Since 1991, the epidemic has increasingly been dominated by serogroup B meningococci with subtype P1.7b,4, which by 2000 accounted for 84.6% of all cases for whom this testing was carried out. The majority of these organisms were characterised as B:4:P1.7b,4.CONCLUSION: Meningococcal disease rates are likely to remain elevated in New Zealand for at least several more years. A vaccine which could induce immunity to the P1.7b,4 PorA subtype may have a role in controlling this epidemic. Efforts are underway to obtain and trial such a vaccine. Measures are also underway to reduce overcrowded living conditions which are contributing to the epidemic. Early recognition and antibiotic treatment of cases improves outcomes and should continue to be promoted. Integrated notification and laboratory-based surveillance of meningococcal disease provides relatively complete surveillance of this disease in New Zealand and has supported the development of public health interventions.