Control of group C meningococcal disease in Australian aboriginal children by mass rifampicin chemoprophylaxis and vaccination

Lancet. 1995 Jul 1;346(8966):20-3. doi: 10.1016/s0140-6736(95)92651-8.

Abstract

An outbreak of 12 cases of meningitis, 11 caused by Neisseria meningitidis serogroup C, occurred at Doomadgee from September, 1990, to April, 1991. The incidence of meningitis was 17.55/10(3) person-years. Only children aged 1-10 years were affected. In October, 1990, or shortly thereafter, 473/509 children aged between 1 and 15 years inclusive had one dose of Mencevax AC. From the time of vaccination until April, 1991, a further eight cases occurred, six in vaccinated children. Vaccine efficacy in 1-15 year olds was calculated as 77%. Despite this, in April, 1991, the prevalence of antibody to group C polysaccharide in vaccinated children (78%) was not significantly different from that in unvaccinated children and adults. 46 nonresponders were revaccinated, and, in February, 1992, 78% had antibodies to group C polysaccharide. In April, 1991, an estimated 3.0% of the population had group C organisms, carriage being directly related to household crowding. In June, 1991, 2 months after mass prophylaxis with rifampicin, none of these individuals were carriers. In October, 1991, the carriage rate of group C organisms was 0.64%. There have been no further cases caused by the epidemic strain. Although uncrowded housing is a basic need, mass chemoprophylaxis and two doses of vaccine for children should be used in similar outbreaks.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Australia / epidemiology
  • Bacterial Vaccines / therapeutic use*
  • Carrier State / ethnology
  • Carrier State / prevention & control
  • Child
  • Child, Preschool
  • Disease Outbreaks / prevention & control
  • Disease Outbreaks / statistics & numerical data
  • Female
  • Humans
  • Immunization, Secondary
  • Incidence
  • Infant
  • Male
  • Meningitis, Meningococcal / ethnology
  • Meningitis, Meningococcal / prevention & control*
  • Meningococcal Vaccines*
  • Native Hawaiian or Other Pacific Islander* / statistics & numerical data
  • Neisseria meningitidis / immunology*
  • Polysaccharides, Bacterial / therapeutic use*
  • Rifampin / therapeutic use*

Substances

  • Bacterial Vaccines
  • Mencevax AC
  • Meningococcal Vaccines
  • Polysaccharides, Bacterial
  • Rifampin