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South African Medical Journal

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An outbreak of meningococcal meningitis in Gauteng, Spring 1996

T.M. Balfour, M.E. Edginton, H. Koornhof, L. McGee, L. Floyd

Abstract


Objective. To describe a Neisseri.a meningitidis outbreak in Gauteng during the period 1 July to 31 December 1996.
Design. A descriptive study.
Setting. Patients with meningococcal meningitis in Gauteng who had been diagnosed by laboratory means, or notified during the period 1 July to 31 December 1996.
Main outcome measures. Data including age, sex, date of admission to hospital, N. meningitidis serogroup and outcome were collected from Gauteng notification lists, South African Institute of Medical Research (SAIMR) records, a linelist compiled by the Gauteng Health Department, and hospital records.
Results. A total of 201 patients was studied; of this number 87 (43%) had been notified. Seventy per cent of cases were below 30 years of age and 78% were male. More than half (54%) of the cases were from the West Rand. The case fatality rate for 70 cases of known outcome was 14%. Serotyping of 85 isolates.showed that a majority (76%) were serogroup A, with 57% being serogroup A clone 1-1.  Serogroup A clone Ill-I accounted for 14% of the typed isolates. All isolates were
sensitive to penicillin With minimum inhibitory concentrations of < 0.05 /lg/ml.
Conclusion. In 1996 Gauteng experienced an epidemic of serogroup A  meningococcal meningitis. The serotype that caused the majority of cases had been recorded in South Africa before, but serogroup A clone Ill-I, responsible for epidemics spreading across two continents, was recorded in South Africa for the first time. Notification of cases by health workers was inadequate in this epidemic.



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