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Abstract
We describe the epidemiology of invasive meningococcal disease in South Africa from August 1999 through July 2002, as reported to a laboratory-based surveillance system. Neisseria meningitidis isolates were further characterized. In total, 854 cases of laboratory-confirmed disease were reported, with an annual incidence rate of 0.64/100,000 population. Incidence was highest in infants < 1 year of age. Serogroup B caused 41% of cases; serogroup A, 23%; serogroup Y, 21%; serogroup C, 8%; and serogroup W135, 5%. Serogroup B was the predominant serogroup in Western Cape Province, and disease rates remained stable. Serogroup A was most prevalent in Gauteng Province and increased over the 3 years. On pulsed-field gel electrophoresis analysis, serogroup A strains showed clonality, and serogroup B demonstrated considerable diversity. Selected isolates of serogroup A belonged to sequence type (ST)-1 (subgroup I/II) complex, serogroup B to ST-32/electrophoretic type (ET)-5 complex, and serogroup W135 to ST-11/ET-37 complex.
Highlights
We describe the epidemiology of invasive meningococcal disease in South Africa from August 1999 through July 2002, as reported to a laboratory-based surveillance system
The 3 serogroup A pandemic waves reaching the African meningitis belt were caused by clones of subgroup III [11,12], and the recent outbreaks of W135 in West Africa were caused by strains belonging to the electrophoretic type (ET)-37 complex [3,13]
The incidence rates of disease reported to the network increased from 0.52 per 100,000 persons in 1999–2000, to 0.62 in 2000–2001, and 0.77 in 2001–2002 (p
Summary
We describe the epidemiology of invasive meningococcal disease in South Africa from August 1999 through July 2002, as reported to a laboratory-based surveillance system. Occurring predominantly as sporadic disease with seasonal variation in most parts of the world, the highest burden of meningococcal disease occurs in the “meningitis belt” of sub-Saharan Africa, where epidemics are observed regularly [1]. These epidemics were associated with serogroup A and, to a lesser extent, serogroup C. To better understand the recent epidemiology of invasive meningococcal disease in South Africa, we analyzed cases reported to a national laboratory-based surveillance system for a 3-year period, from August 1999 through July 2002. Isolates available from cases reported during this period were characterized further
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