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Abstract
We analysed data on all cases of meningococcal disease (MCD) reported to the Norwegian Notification System for Infectious Diseases during the period 1992–1995. For 1994, additional information on fatalities was gathered. Notifications were received from laboratories and clinicians. A total of 586 patients were included. The incidence decreased from 4.6 per 100 000 in 1992 to 2.4 in 1994, and then rose to 3.7 in 1995. The initial decrease, a trend also observed in previous years, was seen in both main serogroups B and C. This decline was broken with the increase of serogroup B in 1995. MCD predominantly affects children below 5 years and teenagers. In 1994, 17/105 (16%) patients died. Main risk factors for fatal outcome were age above 30 years (adjusted odds ratio (OR) 19.8; 95% confidence interval (CI) 2.4–164), septicaemia (adjusted OR 9.5: 95% CI 2.2–41) and disease caused by strains B:15 (adjusted OR 6.4; 95% CI 1.2–35) or C:2a (adjusted OR 10.1; 95% CI 1.6–62). We conclude that the incidence of MCD in Norway is unpredictable and that the case fatality rate is substantially higher than previously believed.