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Invasive meningococcal disease in children in Jerusalem

  • C. STEIN-ZAMIR (a1), N. ABRAMSON (a1), G. ZENTNER (a1), H. SHOOB (a1), L. VALINSKY (a2) and C. BLOCK (a3)
  • DOI:
  • Published online: 30 July 2007

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 (84·2%) of them in children aged 0–14 years. The annual incidence rate in Jerusalem was higher than the national average (2·45±0·6 vs. 1·13±0·16/100 000 population, P=0·002). Most of the children (82·1%) were from low socio-economic Arab and Jewish ultra-orthodox communities; mortality was higher among Arab than Jewish children (1·3 vs. 0·22/100 000 person-years, P=0·004). 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=0·003) and mortality (30% vs. 6·9%, P=0·014) rates were higher. Serogroup B comprised 77·6% 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.

Corresponding author
*Author for correspondence: Dr C. Stein-Zamir, Jerusalem District Health Office, 86 Jaffa Road, Jerusalem 94341, Israel. (Email:
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Epidemiology & Infection
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