1. Group A meningococcal disease in the U.S. Pacific Northwest: epidemiology, clinical features, and effect of a vaccination control program.
- Author
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Counts GW, Gregory DF, Spearman JG, Lee BA, Filice GA, Holmes KK, and Griffiss JM
- Subjects
- Adult, Child, Evaluation Studies as Topic, Female, Ill-Housed Persons, Humans, Indians, North American, Male, Manitoba ethnology, Meningococcal Infections prevention & control, Oregon, Transients and Migrants, Washington, Bacterial Vaccines, Disease Outbreaks epidemiology, Meningococcal Infections epidemiology, Neisseria meningitidis immunology
- Abstract
In 1975 an outbreak of group A meningococcal disease began in Seattle, Washington, and cases subsequently were recognized throughout the Pacific Northwest. Nearly one-half of the affected persons were Native Americans; two-thirds were alcohol abusers and/or habitués of skid road communities. In Seattle, group A meningococci colonized asymptomatic persons only if these individuals had contact with skid road (P = .006). The epidemic strain may have spread from American Indians in Manitoba, Canada. Traditional migration routes connect the two populations; asymptomatic American Indians on reservations in Washington carried group A meningococci. Vaccination programs were undertaken in four cities but only after cases occurred. In Seattle, vaccination reached 80% of the target population and was associated with a significant decrease in incidence of the disease, but cases recurred after the program ended. The social habits of skid road communities, combined with the "case-triggering" approach to, and premature termination of, vaccination programs, may have resulted in 56% of regional cases occurring after the start of the vaccination program in Seattle.
- Published
- 1984
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