Meningococcal disease in Cape Town

Abstract

Meningococcal disease is a significant cause of morbidity and mortality worldwide. Communities in Cape Town have suffered from large epidemics of meningococcal disease in the past. This review highlights meningococcal disease as an important cause of preventable death and disease by describing recent trends of meningococcal disease in Cape Town and briefly reviews strategies for control and prevention. Notification, mortality and laboratory records were obtained and analysed. Between 1998 and 2002 between 109 and 124 case were reported annually in Cape Town. This number dropped to 93 in 2003 and to 44 in 2004. On average, the reported incidence rate of meningococcal disease was three per 100 000 population and was predominantly due to serogroup B. It occurs sporadically and affects mainly young children. While the number of deaths has remained at between 10 and 20 per year the case fatality rate has increased from lessthan l0% in l998 to l4% in 2003 and 45% in 2004. Though less common than in the past, meningococcal disease has reported a dramatic increased mortality rate in Cape Town in 2004. While it may be that deaths are being selectively reported, a higher index of suspicion, together with early treatment and appropriate chemoprophylaxis is encouraged.