Group-Y Meningococcal Disease

Meningococcal infections have been a serious cause of morbidity and mortality in the military. Although the recent availability of an effective polysaccharide vaccine against group-C infection has resulted in a marked diminution of disease, group-Y meningococcal infections have continued, with an occasional isolated epidemic. Experience with 12 cases of group-Y disease at one U.S. Army training center is presented. Nearly half of the patients presented primarily with evidence of central nervous system involvement. In 4 of the 12 cases meningococcemia alone was the initial presentation; one additional patient with meningococcemia developed meningoencephalitis shortly after hospital admission. There were two cases of primary meningococcal pneumonia. Three of the patients with meningococcemia died; two had clinical or autopsy evidence of a syndrome of disseminated intravascular coagulation. Group-Y meningococcal disease appears to be a virulent infection with a significant mortality rate.