A CLUSTER OF MENINGOCOCCAL DISEASE IN WESTERN SYDNEY, AUSTRALIA INITIALLY ASSOCIATED WITH A NIGHTCLUB

Fourteen cases of meningococcal disease (MD) occurred in August-Septem ber 1996 in western Sydney, Australia. Seven of the 10 young adults af fected had a direct or indirect link with a local nightclub. Ten of 11 systemic meningococcal isolates had the phenotype C:2a:P1.5 and showe d close genetic relationship by pulsed-field gel electrophoresis (PFGE ). Organisms of this phenotype have not previously caused outbreaks in Australia, but have been associated with outbreaks and hyperendemic s erogroup C MD in Europe, Canada, and the United States. This is the la rgest cluster of serogroup C MD reported in urban Australia, and the f irst involving a nightclub. The strain differentiation results were av ailable rapidly enough to augment epidemiological investigations on a daily basis. Public health staff could thus establish links between ca ses quickly, follow the spread of new cases in the community, give acc urate information to health officials and the press, and utilize exist ing knowledge about the characteristics of this phenotype to predict l ikely developments during the outbreak and afterwards. The strain diff erentiation data was also very helpful when the role of vaccination wa s considered, and existing guidelines on the management of outbreaks o f MD could be used effectively for the first time in western Sydney.