Invasive meningococcal disease in children in Jerusalem

Neisseria meningitidis is an important cause of childhood meningitis and septicaemia. Between 1999 and 2005, 133 invasive meningococcal disease (IMD) cases occurred in Jerusalem, 112 (84 center dot 2%,) of them in children aged 0-14 years. The annual incidence rate in Jerusalem was higher than the national average (2 center dot 45+/-0 center dot 6 vs. 1 center dot 13+/-0 center dot 16/100000 population, P=0 center dot 002). Most of the children (82 center dot 1 %) were from low socio-economic Arab and Jewish Ultra-orthodox communities; mortality was higher among Arab than Jewish children (1 center dot 3 vs. 0 center dot 22/100 000 person-years, P=0 center dot 004). A cluster of 10 children with severe meningococcal sepsis (three fatalities) emerged in the winter of 2003-2004. Compared to the other 102 cases in 1999-2005 both meningococcaemia (100% vs. 51% P=0 center dot 003) and mortality (30% vs. 6 center dot 9%, P=0 center dot 014) rates were higher. Serogroup B comprised 77 center dot 6% of the bacterial isolates. Pulsed-field gel electrophoresis showed considerable variability among Cluster isolates, but significant resemblance in Arab cases throughout 1999-2005. The increased Susceptibility of specific sub-populations to IMD necessitates further evaluation.