ASSESSMENT OF SURVEILLANCE FOR MENINGOCOCCAL DISEASE IN NEW-YORK-STATE, 1991

Prevention of meningococcal disease relies in part on the prompt treat ment of household and other close contacts of cases. New York State re quires that all meningococcal disease cases be reported within 24 hour s of diagnosis to ensure that chemoprophylaxis is given to all exposed persons. The authors used a capture-recapture method to assess comple teness of reporting of meningococcal disease in 1991 by comparing pers ons reported to the Department of Health surveillance system with pati ents listed in the New York State computerized hospital discharge data set who had a discharge diagnosis of meningococcal disease, Medical r ecords of persons identified from the discharge data set were reviewed to verify the diagnosis of meningococcal disease, and timeliness of r eporting was assessed by reviewing surveillance case reports. In 1991, 110 cases of meningococcal disease were reported to the Department of Health and 197 patients were identified from hospital discharge data, of which charts were reviewed for 179 (91%). Of the charts reviewed, 116 (65%) had confirmed or probable meningococcal disease, and 57 (32% ) did not have the disease. Completeness of reporting to the notifiabl e disease surveillance system was estimated to be 93%, and 78% were re ported within 2 days of diagnosis. Errors by physicians and medical re cords departments contributed to the misclassification of medical reco rds. The authors conclude that notifiable disease surveillance for men ingococcal disease is relatively complete, but there is a delay in rep orting some cases. Frequent errors may make invalidated hospital disch arge data unsuitable for communicable disease surveillance.