TY - JOUR
T1 - Group A meningococcal disease in the U.S. Pacific Northwest
T2 - epidemiology, clinical features, and effect of a vaccination control program.
AU - Counts, G. W.
AU - Gregory, D. F.
AU - Spearman, J. G.
AU - Lee, B. A.
AU - Filice, G. A.
AU - Holmes, K. K.
AU - Griffiss, J. M.
PY - 1984
Y1 - 1984
N2 - 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.
AB - 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.
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U2 - 10.1093/clinids/6.5.640
DO - 10.1093/clinids/6.5.640
M3 - Article
C2 - 6209769
AN - SCOPUS:0021490628
SN - 1058-4838
VL - 6
SP - 640
EP - 648
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 5
ER -