40 YEARS OF MENINGOCOCCAL DISEASE IN ISRAEL - 1951-1990

Meningococcal disease accounts for approximately 20% of cases of bacte rial meningitis in Israel. During the period 1951-1990, the annual inc idence of meningococcal disease rarely exceeded two cases per 100,000 persons and was generally higher among non-Jews (largely the Arab popu lation) than among Jews; there were some notable peaks of disease acti vity during 1963-1967, 1975, and 1987-1988. The highest incidence was among infants and young children, with a slight male predominance. The main period of disease activity was from January to April, but an unu sual secondary peak in July coincided with the onset of peak summer te mperatures. Monthly disease frequencies were significantly correlated with relative humidity. Incidence rates varied between regions and wer e lower in cities than in smaller settlements. Overall case-fatality r ates decreased to approximately 11% for the period 1981-1990. Outbreak s were infrequent and tended to be small. Meningococci of serogroup B have dominated since the mid-1970s. Group A meningococci were isolated significantly more commonly from Arabs (26.26%) than from Jews (1.03% ; P < .000001). The frequency with which group A organisms occurred am ong clinical isolates appeared to follow a more or less cyclical patte rn.