Abstract
BackgroundFew published reports have evaluated the clinical features and outcome of serogroup W135 meningococcal disease. In Taiwan, W135 is the second most prevalent meningococcal disease serogroup.MethodA nationwide study was conducted to retrospectively analyze epidemiologic data from 115 patients with laboratory confirmed meningococcal disease that occurred from 2001 through 2003.ResultsSerogroup W135 accounted for 26% of all cases and most (76.7%) were older than 20 years. There were no cases of serogroup W135 meningococcal disease associated with Hajj pilgrims, and all cases were sporadic. In 88 patients with complete case records, we compared the presenting symptoms, signs, laboratory data, and outcomes between W135 and non-W135 patients. There were no differences in presenting symptoms except for the higher prevalence of pneumonia found in W135 patients (23.8% vs. 1.5%; OR: 20.6; 95%CI: 2.3–189.0; p = 0.003). The distribution of inflammatory cells in CSF in patients with meningitis was also different between W135 and non-W135 patients. W135 patients had a trend toward more intubations and shock but it did not achieve statistical significance. In multivariate analysis of factors associated with death, three independent factors were found: bacteremia without meningitis, altered mental status, and petechiae or purpura on admission.ConclusionSporadic serogroup W135 meningococcal disease is an important component of the meningococcal disease burden in Taiwan, but it is not directly associated with Hajj pilgrims. Compared with patients infected by other serogroups of meningococci, patients with serogroup W135 were older and more likely to have extrameningeal involvement such as pneumonia.
Highlights
Few published reports have evaluated the clinical features and outcome of serogroup W135 meningococcal disease
Little is known about the clinical features and outcome of serogroup W135 disease [9,10,11], but there are some reports of extrameningeal complications [11,12,13]
Case reporting and microbiology laboratory procedures In the National Notifiable Disease Surveillance System in Taiwan, patients with sudden onset of fever, headache, nausea, vomiting, stiff neck, petechial rash with pink macules, accompanied by delirium, coma or shock; or Gramnegative diplococci were found in smear of cerebrospinal fluid by Gram-stain should be reported to the Center for Disease Control (CDC), Taiwan as suspected cases of invasive meningococcal disease within 24 hours
Summary
Few published reports have evaluated the clinical features and outcome of serogroup W135 meningococcal disease. In Taiwan, W135 is the second most prevalent meningococcal disease serogroup. An outbreak of serogroup W135 meningococcal infection in Saudi Arabia following the 2000 Hajj was reported, and spread to several countries around the world [2,3,4]. In the period from 2001 through 2003, about 20 to 40 pilgrims per year went from Taiwan to Saudi Arabia for the Hajj (data from Chinese Muslim Association, Taiwan). Little is known about the clinical features and outcome of serogroup W135 disease [9,10,11], but there are some reports of extrameningeal complications [11,12,13]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
