Meningococcal Disease in Taiwan 1996-2001: Epidemiology and Risk Factors for Death

I-Chen Lai

2008 Vol.24 NO.6

Correspondence Author： I-Chen Lai

Abstract：

The incidence rate of meningococcal disease (MCD) was very low during last two decade in Taiwan, but the morbidity and fatality rate increased in 2000. We performed this study to review the epidemiology of MCD, and identify risk factors that may influence mortality. We performed a retrospective case-control study collecting the demographic characteristics, diagnoses and review of medical records of all the patients whom were reported through passive surveillance system from Jan. 1994 to Jun. 1998. A total of 115 patients were included. Average annual incidence was <0.02 per 100,000 population. Overall case fatality rate was 16.5%. On admission, the following clinical signs were significantly associated with fatality: fever, headache, neck stiffness, skin purpura (or petechia), and meningococcemia without meningitis. The laboratory parameters associated with death were a normal/low white blood cell count and a high serum GOT. The timing of antibiotics given also had influence on fatality. Parenteral antibiotics given before admission probably contributed to a reduction in the case fatality rate from MCD, and primary care physicians should be encouraged to give such treatment immediately on suspicion of the diagnosis before transferring the patient to hospital.
Keywords:meningococcal disease, epidemiology, risk factors for death