N. meningitidis는 지속적으로 감소되어 왔습니다. 그렇지만 전체 인구보다도 2세 미만 소아에서 거의 10배 가량 높습니다. 고위험 그룹은 6개월~2세 사이의 소아와 대학교 신입생, 신병(군인)들입니다.
N. meningitidis can cause both endemic and epidemic infection. Meningococcal infections are endemic in the United States, and the annual incidence of invasive meningococcal disease varies in multiyear cycles; the most recent peak in incidence occurred during the mid-1990s. Between 2005 and 2011, the incidence of meningococcal disease in the United States was 0.3 cases per 100,000 population. Disease rates are almost 10 times higher in children below two years of age than in the overall population.
Meningococcal disease incidence*, by year - United States, 1984 to 2014 In 2014, meningococcal disease incidence remained at a historic low in the United States. However, Neisseria meningitidis remains an important cause of bacterial meningitis and sepsis in the United States.* Per 100,000 population.Reproduced from: Adams DA, Thomas KR, Jajosky RA, et al. Summary of Notifiable Infectious Diseases and Conditions - United States, 2014. MMWR Morb Mortal Wkly Rep 2016; 63:1.
College campuses에서 수막구균 outbreaks가 상당한 주목을 받았습니다. 연구들에서 발생률은 freshmen living in dormitories 또는 first-year students에서 가장 높았습니다.
Outbreaks of meningococcal infection on college campuses have attracted considerable attention [16-19]. A retrospective cohort study did not reveal an increase in the incidence of meningococcal infection in college students compared with age-matched controls (1.74 versus 1.44 per 100,000). However, among affected college students, the rates of illness were higher for those residing on campus. Another case-control study performed in college students determined that the incidence of infection was lower than the general population of 18- to 23-year-old nonstudents (0.7 versus 1.4 per 100,000); however, the incidence was highest in freshmen living in dormitories (5.1 per 100,000), and the risk for disease by multivariate analysis was 3.6 for this group compared with other college students. A study from the United Kingdom also found that having a high proportion of first-year students in a residence hall increased the risk for meningococcal infection.
대규모 epidemics은 sub-Saharan Africa를 가로 지르는 소위 meningitis belt에서 상당한 빈도로 발생합니다(총 인구의 1000명 당 1명, 2세 이하 소아에서는 100명 당 1명)
Large-scale epidemics occur with considerable frequency in the so-called "meningitis belt," which crosses the waist of sub-Saharan Africa. The case rate during these epidemics can be as high as 1 in 1000 total population and 1 in 100 for children below two years of age. Travelers may be at risk for acquiring meningococcal infection, especially when traveling to regions at risk for epidemics or hyperendemic for the disease and for those with extensive contact with local residents. The Hajj pilgrimage to Mecca has been associated with outbreaks of meningococcal infection; pilgrims are required by the government of Saudi Arabia to be vaccinated.
Areas with frequent epidemics of meningococcal meningitis, isease data source: World Health Organization. International Travel and Health. Geneva, Switzerland: 2012.Reproduced from: The Centers for Disease Control and Prevention and Brunette GW (Ed). CDC Health Information for International Travel 2018. Oxford University Press, New York, 2017.
REF. UpToDate 2019.05.06
