Meningococcal serogroup B outbreak response University of Wisconsin-Madison.

A meningococcal serogroup B (MenB) outbreak at a large public university prompted an emergency response to immunize undergraduates. OBJECTIVE: To report on a successful meningococcal serogroup B (MenB) vaccine clinic response at a large public university. METHODS: We assembled the team leaders to write this case report. RESULTS: Activation of the emergency plan and points of dispensing required cooperation of many units on campus under the leadership of university health officials with support from Centers for Disease Control and Prevention, state division of public health and the city-county health department. Significant efforts to provide consistent messages to students and parents regarding the outbreak and the availability of the MenB vaccines were made. Volunteers were recruited to staff the clinics alongside university healthcare providers. Over 22,000 doses of vaccine were administered. CONCLUSION: We report our experience and lessons learned which may be helpful to universities in preventing and responding to disease outbreaks.

Meningococcal disease incidence and mortality in Wisconsin, 1993-2002.

Neisseria meningitidis is a major cause of sepsis and meningitis in children and young adults in the United States. To examine recent epidemiologic features of meningococcal disease in Wisconsin, we evaluated Wisconsin case surveillance data collected during 1993-2002. Surveillance data for cases with onsets during this time were analyzed; statistical trends were assessed. Mortality was examined with regard to age, sex, serogroup, college student status, and young adult status by unadjusted and adjusted analyses. During 1993-2002, 462 cases of meningococcal disease were reported in Wisconsin; 55% of case patients were aged < 19 years. The annual incidence was 0.9 cases per 100,000 persons per year, and incidence was highest among children aged <2 years. Two seasonal peaks in cases were observed during January-April and September-October. The annual mortality rate during the 10-year interval was 0.09 deaths per 100,000 persons per year. Adjusted analysis indicated that serogroup C infection, young adult, and college student status (but not sex) were associated with mortality. Meningococcal disease remains uncommon and sporadic in Wisconsin. Incidence and mortality rates are highest among young children, but young adults who acquire the disease appear to be at an increased mortality risk.

Multistate outbreak of Listeria monocytogenes infection linked to delicatessen turkey meat.

BACKGROUND: Despite a decreasing incidence of listeriosis in the United States, molecular subtyping has increased the number of recognized outbreaks. In September 2000, the New York City Department of Health identified a cluster of infections caused by Listeria monocytogenes isolates with identical molecular subtypes by pulsed-field gel electrophoresis (PFGE) and ribotyping. METHODS: To determine the magnitude of the outbreak and identify risk factors for infection, we notified state health departments and conducted a case-control study. A case was defined as a patient or mother-infant pair infected with Listeria monocytogenes whose isolate yielded the outbreak PFGE pattern. Controls were patients infected with Listeria monocytogenes whose isolate yielded a different PFGE pattern. Patients were asked about food and drink consumed during the 30 days before the onset of illness. RESULTS: Between May and December 2000, there were 30 clinical isolates of Listeria monocytogenes with identical PFGE patterns identified in 11 US states. Cases of infection caused by these isolates were associated with 4 deaths and 3 miscarriages. A case-control study implicated sliced processed turkey from a delicatessen (Mantel-Haenszel odds ratio, 8.0; 95% confidence interval, 1.2-43.3). A traceback investigation identified a single processing plant as the likely source of the outbreak, and the company voluntarily recalled 16 million pounds of processed meat. The same plant had been identified in a Listeria contamination event that had occurred more than a decade previously. CONCLUSIONS: Prevention of persistent L. monocytogenes contamination in food processing plants presents a critical challenge to food safety professionals.