OUTBREAK OF SEROGROUP-C MENINGOCOCCAL DISEASE-ASSOCIATED WITH CAMPUS BAR PATRONAGE

Between February 1991 and April 1992, eight undergraduates at a US res idential university and one at a nearby 2-year college contracted sero group C meningococcal disease, A case-control investigation with 20 co ntrols per case, oropharyngeal carriage surveys, and multilocus enzyme electrophoresis (MEE) of serogroup C isolates were used to identify f actors contributing to the outbreak. All eight sterile-site isolates f rom cases were closely related by MEE and were similar (though not ide ntical) to the strain associated with the 1991-1992 epidemic of mening ococcal disease in eastern Canada. Disease was associated with cigaret te smoking (p = 0.012), recent patronage of campus-area bars (p = 0.03 4), estimated amount of time spent in campus-area bars (p = 0.0003), a nd, especially, recent patronage of one specific bar, bar A (p = 0.000 6; odds ratio = 23.1, 95% confidence interval 3.0-571.5). In carriage surveys, 1,528 throat cultures taken from (primarily student) noncases yielded only five (0.3%) strains that were identical by MEE to those from cases. Two of these were found among 22 cultures obtained from ba r A employees in spring 1992. Some cases in this outbreak may have fol lowed transmission of the epidemic strain in bar A. Campus bar environ ments may facilitate the spread of meningococcal disease among teenage rs and young adults.