Analysis of N. Meningitidis in Texas for 2007

Background:
All reported cases of invasive meningococcal infection are investigated. The Texas Administrative Code states that all meningococcal infection, invasive (N. meningitidis from normally sterile sites) shall be submitted as pure cultures to the Department of State Health Services (DSHS), Laboratory Services Section, as they become available. After the submission of the isolates to the DSHS lab, serogrouping and Pulsed Field Gel Electrophoresis (PFGE) analysis for each case of N. meningitidis is performed.

Setting:
Texas statewide surveillance.

Population:
2007 N. meningitidis cases reported in Texas.

Project Description:
Information from lab analysis at DSHS during 2007 was contrasted with epidemiologic information collected from case information. Clinical presentation of the case was categorized by serogroup.

Results/Lessons Learned:
In 2007, 55 cases of N. meningitidis reported to the DSHS. Fifty-two cases were confirmed and 3 were probable. Of the 52 confirmed cases, 46 isolates were submitted to the DSHS lab for serogrouping and PFGE analysis. Of the 46 isolates, 41 were serogrouped. Serogrouping was not determined for the remaining 5 isolates. Of the 41 isolates, 15 were serogroup B, 14 were serogroup C, and 12 were serogroup Y.
The clinical presentation associated with N. meningitidis infection by serogroup B included, 4 with bacteremia, 1 with bacteremia and meningitis, and 10 with meningitis. Cases with serogroup C infections included, 3 with bacteremia, 8 with meningitis, 1 with meningococcemia, 1 with pericarditis, and 1 with septic arthritis. Cases with serogroup Y infections included, 6 with bacteremia, 1 with bacteremia and pneumonia, and 5 were meningitis.
Five isolates were not serogrouped. 2 were sent to Centers for Disease Control and serogrouped by PCR, 2 were non groupable, and 1 had no growth on the culture. Forty-two of the 46 isolates had PFGE analysis performed.