Abstract
For the last ten years, meningococcal disease has been endemic in Italy with an annual average of 900 cases (rate of 1.6/100,000). The age specific attack rate has been highest for children under one year of age, and the majority of cases have been due to serogroup B. During 1985, the epidemiology of meningococcal disease changed substantially: twice as many cases were observed in males as in females. There was a shift toward older age groups, with the highest number of cases occurring in the 15-24 year old age group (25%). The frequency in army recruits was 17.3/100,000, as opposed to 1/100,000 for the general population. Serogroup C caused the majority of cases (75.8% of the isolates). The proportion of strains resistant to sulfonamides was 71.1%, while only one strain was resistant to rifampin and none to minocycline. Seven secondary cases occurred (2%): in five, chemoprophylaxis was inappropriate (sulfonamide), and in two, no drug was given. A single co-primary case was seen. We conclude that in Italy, the use of sulfa drugs as chemoprophylactic agents is not warranted at present, compulsory vaccination of army recruits with bivalent vaccine (A + C) is advisable, and the shift in age distribution of cases and the high predominance of serogroup C increases the need for careful surveys.
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