Outbreak of meningococcal disease in western Norway due to a new serogroupC variant of the ET-5 clone: effect of vaccination and selective carriage eradication

A new sulphonamide resistant (SR) C:15:P1.7,16 meningococcal strain, a vari ant of the ET-5 clone, dominated in an outbreak of 22 cases in western Norw ay commencing in 1995. The first eight patients were 15-21 years old from t he Nordhordland area, initiating a carrier study in the local high schools. Carriage of SR serogroup C meningococci was detected by routine methods an d treated with a single dose of ofloxacin 400 mg. Of 20 treated carriers, 1 4 harboured the outbreak strain C: 15:P1.7,16. Vaccination of 4000 children , adolescents and close contacts of patients was also performed. After the intervention, 14 additional cases of meningococcal disease occurred, 8 due to the outbreak strain. However, incidence rates dropped from 180 to 30 per 100000 per year in the student population, but increased from 0 to 13 in t he rest of the population in Nordhordland. Carriage eradication is not gene rally recommended in Norway. However, tracing and treating meningococcal ca rriage may have reduced transmission and disease in this outbreak situation .