Invasive Meningococcal Disease, US–Mexico Border | CDC EID

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Volume 17, Number 3–March 2011
Dispatch
Surveillance for Invasive Meningococcal Disease in Children, US–Mexico Border, 2005–20081
Enrique Chacon-Cruz, David E. Sugerman, Michele M. Ginsberg, Jackie Hopkins, Jose Antonio Hurtado-Montalvo, Jose Luis Lopez-Viera, Cesar Arturo Lara-Muñoz, Rosa M. Rivas-Landeros, Maria Luisa Volker, and John A. Leake

Author affiliations: General Hospital of Tijuana, Tijauna, Mexico (E. Chacon-Cruz, J.A. Hurtado-Montalvo, J.L. Lopez-Viera, C.A. Lara- Muñoz, R.M. Rivas-Landeros, M.L. Volker); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (D. Sugerman); San Diego County Health and Human Services Agency, San Diego, California, USA (M.M. Ginsberg, J. Hopkins); Rady Childrens Hospital, San Diego (J. Leake); and University of California, San Diego (J. Leake)

Suggested citation for this article


Abstract
We reviewed confirmed cases of pediatric invasive meningococcal disease in Tijuana, Mexico, and San Diego County, California, USA, during 2005–2008. The overall incidence and fatality rate observed in Tijuana were similar to those found in the US, and serogroup distribution suggests that most cases in Tijuana are vaccine preventable.

Invasive meningococcal disease (IMD) is caused by Neisseria meningitidis. Specific antibodies against the capsule are used to define the 13 known N. meningitidis serogroups (1). In the United States, N. meningitidis is a leading cause of bacterial meningitis (2,3). According to the provisional Active Bacterial Core Surveillance report of the Centers for Disease Control and Prevention, 1,050 cases of IMD were estimated to occur in 2008, with an overall incidence of 0.33/100,000 population and mortality rate of 0.03/100,000 population. Higher age-specific incidence and proportion of deaths occur in children and adolescents (4). In the United States, Active Bacterial Core Surveillance data show that serogroups B (0.11/100,000), C (0.11/100,000), and Y (0.08/100,000) are predominant (5).

IMD is a reportable condition in both the United States and Mexico. In 2006, the Mexican National Epidemiologic Surveillance System reported 60 cases in Mexico (population 105,790,700) for a nationwide rate of 0.056/100,000 (6). However, only a limited number of epidemiologic descriptions of IMD, primarily from outbreaks, are available from Mexico. For example, an outbreak of 753 cases was recorded during 1945–1949 in San Luis Potosi. Most cases were among infants and young children; serogroup data were not available (7).

Although physicians in Mexico at the US–Mexico border areas often encounter patients with symptoms highly compatible with IMD, diagnosis is not routinely culture-confirmed; this likely leads to underreporting. Serogroup-specific data on IMD are also lacking elsewhere throughout Mexico. The goals of our study were to compare hospital-based estimates of IMD in children and serogroup distribution at Tijuana General Hospital (TGH), Mexico, with a catchment population of nearly 200,000 children <17 years, to reported IMD cases in children in San Diego County (SDC), with a population of 723,600 children <17 years. (All demographic and serogroup data are listed in the Table.) This border is the most traversed international frontier in the world. We hypothesized that rates of IMD are underreported at TGH and that serogroup distribution is similar on both sides of the US–Mexico border. full-text: Invasive Meningococcal Disease, US–Mexico Border | CDC EID


Suggested Citation for this Article
Chacon-Cruz E, Sugerman DE, Ginsberg MM, Hopkins J, Jose Hurtado-Montalvo A, Jose Luis Lopez-Viera JL, et al. Surveillance for invasive meningococcal disease in children, US–Mexico border, 2005–2008. Emerg Infect Dis [serial on the Internet]. 2011 Mar [date cited].
http://www.cdc.gov/EID/content/17/3/543.htm

DOI: 10.3201/eid1703.101254


1Preliminary results of this study were presented as a poster at the 14th Pan-American Congress on Infectious Diseases, Campos do Jordao, Brazil, April 25–28, 2009.


Comments to the Authors
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Enrique Chacon-Cruz, 511 E San Ysidro Blvd, No. 1812, San Ysidro, CA 92173-3110, USA; email: echacon88@hotmail.com