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Epidemic Meningococcal Disease in Nairobi, Kenya, 1989

Robert W. Pinner, Francis Onyango, Bradley A. Perkins, Nazir B. Mirza, Dorothy M. Ngacha, Michael Reeves, Wallis DeWitt, Erastus Njeru, Naphtali N. Agata, Claire V. Broome and Kenya/Centers for Disease Control(CDC)Meningitis Study Group
The Journal of Infectious Diseases
Vol. 166, No. 2 (Aug., 1992), pp. 359-364
Published by: Oxford University Press
Stable URL: http://www.jstor.org/stable/30112936
Page Count: 6
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Epidemic Meningococcal Disease in Nairobi, Kenya, 1989
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Abstract

An epidemic of meningococcal disease occurred in Nairobi, Kenya, during 1989, outside the "meningitis belt" of sub-Saharan Africa. About 3800 cases occurred between April and November (250/100,000 population). The case-fatality rate was 9.4% among hospitalized patients. Areas that included Nairobi's largest slums had particularly high attack rates. The epidemic displayed an unusual age distribution, with high attack rates among those 20-29 years old. A vaccination campaign was conducted. By early January, the weekly case count had fallen to 25 from a high of 272 (in September). A case-control study estimated the vaccine efficacy to be 87% (95% confidence interval, 67%-95%). A model estimated that the vaccination campaign reduced the number of cases by at least 20%. Multilocus enzyme electrophoretic typing demonstrated that the strain responsible for this large epidemic is closely related to strains that caused other recent epidemics, documenting further spread of what may be a particularly virulent clonal complex of group A Neisseria meningitidis.

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