The Worldwide Prevention of Meningococcal Infection

Few organisms evoke more fear among the public thanNeisseria meningitidis, particularly when it occurs in outbreaks and epidemics. The meningococcus is among a limited number of endemic pathogens in industrialized nations that can kill a healthy young adult within several hours. Large epidemics ofN meningitidisinfection occurred in the United States until 1944 and still occur in the nonindustrialized world. Attack rates can approach 1% and millions of cases can occur during a meningococcal epidemic.¹ The meningococcus is a leading cause of bacterial meningitis and bacteremia in the United States. An estimated 2600 cases occur each year, almost half among children 2 years old and younger.²The annual incidence of meningococcal infection is approximately one case per 100 000 population. Survivors of meningococcal infection often suffer severe sequelae.³The meningococcus has taken on an increased relative importance in the United States since the decline of