An outbreak of meningococcal meningitis in Gauteng, spring 1996

Objective. To describe a Neisseria meningitidis outbreak in Gauteng during the period 1 July to 31 December 1996. Design. A descriptive study. Setting. Patients with meningococcal meningitis in Gauteng who had been dia gnosed by laboratory means, or notified during the period 1 July to 31 Dece mber 1996. Main outcome measures. Data including age, sex, date of admission to hospit al, N, meningitidis serogroup and outcome were collected from Gauteng notif ication lists, South African Institute of Medical Research (SAIMR) records, a linelist compiled by the Gauteng Health Department, and hospital records . Results. A total of 201 patients was studied; of this number 87 (43%) had b een notified. Seventy per cent of cases were below 30 years of age and 78% were male. More than half (54%) of the cases were from the West Rand. The c ase fatality rate for 70 cases of known outcome was 14%. Serotyping of 85 i solates showed that a majority (76%) were serogroup A, with 57% being serog roup A clone I-1. Serogroup A clone III-1 accounted for 14% of the typed is olates. All isolates were sensitive to penicillin with minimum inhibitory c oncentrations of < 0.05 mu g/ml. Conclusion. In 1996 Gauteng experienced an epidemic of serogroup A meningoc occal meningitis. The serotype that caused the majority of cases had been r ecorded in South Africa before, but serogroup A clone III-1, responsible fo r epidemics spreading across two continents, was recorded in South Africa f or the first time. Notification of eases by health workers was inadequate i n this epidemic.