%0 Journal Article %1 zangwill_school-based_1997 %A Zangwill, K M %A Schuchat, A %A Riedo, F X %A Pinner, R W %A Koo, D T %A Reeves, M W %A Wenger, J D %D 1997 %J JAMA: The Journal of the American Medical Association %K Absenteeism, Adolescent, Analysis, Child, Cluster Factors, Humans, Infections, Logistic Meningococcal Models, Neisseria Preschool, Prospective Risk Schools, Serotyping, States Studies, United meningitidis, {Case-Control} %N 5 %P 389--95 %R 9010171 %T School-based clusters of meningococcal disease in the United States. Descriptive epidemiology and a case-control analysis %V 277 %X OBJECTIVE: To evaluate the epidemiologic features and risk factors for multiple cases of meningococcal disease in schools. DESIGN: Population-based prospective evaluation and case-control study of clusters of meningococcal disease that occurred in schools from January 1989 to June 1994. SETTING: Surveillance conducted through state health departments in the United States. MAIN OUTCOME MEASURES: Descriptive epidemiology of school-based clusters of meningococcal disease and determinants of their occurrence. RESULTS: We identified 22 clusters of meningococcal disease in 15 states. The estimated incidence of secondary meningococcal disease among schoolchildren aged 5 to 18 years was 2.5 per 100000 population, a relative risk of 2.3 (95\% confidence interval CI, 1.6-3.3). The median number of students per cluster was 2 (range, 2-4). Of 30 subsequent cases, 10 (33\%) occurred 2 or fewer days after the index case, and 22 (73\%) occurred 14 or fewer days after the index case. Among the 8 schools with 2 or more cases, 50\% of the additional cases occurred 2 or more days after the second case. Secondary schools (grades 7 through 12) accounted for 15 (75\%) of 20 cluster schools compared with 9 (45\%) of 20 matched control schools (P\textless.05). In 16 (73\%) of 22 clusters, interaction between case patients was noted. The index patient in cluster schools was more likely than the controls to have participated in a school-based group activity 14 or fewer days before illness (matched odds ratio, 7.0; 95\% CI, 0.9-57). CONCLUSIONS: Three quarters of the school clusters occurred in secondary schools, with over 70\% of subsequent cases occurring within 2 weeks of the index case. Rapid initiation of a chemoprophylaxis program after 2 cases of meningococcal disease in a school would have potentially prevented 50\% of subsequent cases in the clusters described.

@article{zangwill_school-based_1997, abstract = {{OBJECTIVE:} To evaluate the epidemiologic features and risk factors for multiple cases of meningococcal disease in schools. {DESIGN:} Population-based prospective evaluation and case-control study of clusters of meningococcal disease that occurred in schools from January 1989 to June 1994. {SETTING:} Surveillance conducted through state health departments in the United States. {MAIN} {OUTCOME} {MEASURES:} Descriptive epidemiology of school-based clusters of meningococcal disease and determinants of their occurrence. {RESULTS:} We identified 22 clusters of meningococcal disease in 15 states. The estimated incidence of secondary meningococcal disease among schoolchildren aged 5 to 18 years was 2.5 per 100000 population, a relative risk of 2.3 (95\% confidence interval {[CI],} 1.6-3.3). The median number of students per cluster was 2 (range, 2-4). Of 30 subsequent cases, 10 (33\%) occurred 2 or fewer days after the index case, and 22 (73\%) occurred 14 or fewer days after the index case. Among the 8 schools with 2 or more cases, 50\% of the additional cases occurred 2 or more days after the second case. Secondary schools (grades 7 through 12) accounted for 15 (75\%) of 20 cluster schools compared with 9 (45\%) of 20 matched control schools {(P{\textless}.05).} In 16 (73\%) of 22 clusters, interaction between case patients was noted. The index patient in cluster schools was more likely than the controls to have participated in a school-based group activity 14 or fewer days before illness (matched odds ratio, 7.0; 95\% {CI,} 0.9-57). {CONCLUSIONS:} Three quarters of the school clusters occurred in secondary schools, with over 70\% of subsequent cases occurring within 2 weeks of the index case. Rapid initiation of a chemoprophylaxis program after 2 cases of meningococcal disease in a school would have potentially prevented 50\% of subsequent cases in the clusters described.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Zangwill, K M and Schuchat, A and Riedo, F X and Pinner, R W and Koo, D T and Reeves, M W and Wenger, J D}, biburl = {https://www.bibsonomy.org/bibtex/2a0207c3a2307b3f060a17d275813a7de/jelias}, doi = {9010171}, interhash = {0f13e8cae59287884599d70eb5a47101}, intrahash = {a0207c3a2307b3f060a17d275813a7de}, issn = {0098-7484}, journal = {{JAMA:} The Journal of the American Medical Association}, keywords = {Absenteeism, Adolescent, Analysis, Child, Cluster Factors, Humans, Infections, Logistic Meningococcal Models, Neisseria Preschool, Prospective Risk Schools, Serotyping, States Studies, United meningitidis, {Case-Control}}, month = feb, note = {{PMID:} 9010171}, number = 5, pages = {389--95}, timestamp = {2011-03-11T10:06:22.000+0100}, title = {School-based clusters of meningococcal disease in the United States. Descriptive epidemiology and a case-control analysis}, volume = 277, year = 1997 }