Learning Objectives for this Presentation:
By the end of this presentation participants will be able to describe the burden of meningococcal disease in the United States and understand the recommendations developed for implementation of the meningococcal conjugate vaccine.

Background:
Neisseria meningitidis is a leading cause of bacterial meningitis in the United States. Meningococcal disease causes substantial mortality and morbidity. In 2005 a conjugate meningococcal vaccine for serogroups A, C, Y, and W-135 was licensed and recommendations were made for routine vaccination in adolescent age groups. Determining the burden of disease prior to widespread use of this vaccine is important in evaluating its impact on meningococcal disease.

Objectives:
To describe the burden of meningococcal disease in the United States from 2000-2004.

Methods:
We conducted active laboratory-based surveillance for meningococcal disease from 2000-2004 in ten sites through the Active Bacterial Core Surveillance/Emerging Infections Program (surveillance population 38.6 million). A confirmed case was defined by isolation of N. meningitidis from a normally sterile body site from a person with a clinically compatible illness. All isolates were serogrouped by standard methods.

Results:
In total, 850 N. meningitidis cases were reported from 2000-2004 with an overall case fatality rate of 12.5%. Persons aged 11-22 years contributed 23% (n=195) of cases and 24 deaths, resulting in a case fatality rate of 12.3%. Sixty-three percent of the cases and 70% of deaths in persons aged 11-22 years were vaccine preventable (serogroups A, C, Y or W-135). In 2004 the overall rate of meningococcal disease was 0.31/100,000 population, in persons aged 11-17 years 0.36/100,000 population and higher in persons 18-22 years (0.67/100,000 population).

Conclusions:
The recommendations for implementation of the conjugate meningococcal vaccine should impact rates of meningococcal disease in the adolescent and young adult age group; however, disease caused by non-vaccine serogroups will continue to occur.