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First recorded outbreaks of meningococcal disease in the Israel Defence Force: Three clusters due to serogroup C and the emergence of resistance to rifampicin

Ausbrüche von Meningokokkenerkrankungen im israelischen Militär: Erste Dokumentation mit drei Erkrankungsherden durch Serogruppe C und Resistenzentwicklung gegen Rifampicin

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Summary

Outbreaks of meningococcal disease were observed for the first time in the Israel Defence Force (I. D. F.) in 1992 and 1993, while in previous years, cases appeared in sporadic fashion. Two episodes in the winter of 1992 involving three and two individuals, respectively, were caused byNeisseria meningitidis group C, which was notypable and nonsubtypable (C:NT:-). Three cases in one event in early 1993 were due to group C:NT:P1.2, the two secondary cases being caused by strains completely resistant to rifampicin. While these outbreaks were small, they should be seen against a background of the emergence of relatively virulent clones of serogroup C which have caused significant outbreaks in several countries. This and the drug resistance problem will require medical decision-makers to review strategies for the prevention of meningococcal disease, taking into account alternative agents for chemoprophylaxis as well as a possible role for vaccination.

Zusammenfassung

In den Jahren 1992 und 1993 wurden erstmals im israelischen Militär Ausbrüche von Meningokokkenerkrankungen beobachtet, vorher waren nur sporadische Fälle aufgetreten. Bei zwei Episoden im Winter 1992 waren drei beziehungsweise zwei Personen betroffen. Der Erreger warNeisseria meningitidis Gruppe C; die Isolate waren nicht typisierbar oder subtypisierbar (C : NT :-). Drei Fälle, die Anfang 1993 auftraten, wurden durch Gruppe C : NT : P1.2 verursacht; die beiden sekundären Fälle wurden durch Stämme ausgelöst, die gegen Rifampicin vollständig resistent waren. Wenn diese Ausbrüche auch klein waren, sollte bedacht werden, daß in verschiedenen Ländern relativ virulente Stämme von Serogruppe C auftraten, die umfangreiche Epidemien ausgelöst haben. Aus diesem Grund und wegen des Problems der Antibiotikaresistenz sollten Fachgremien die Strategien für die Prävention der Meningokokkeninfektion neu überdenken und alternative Substanzen für die Chemoprophylaxe einbeziehen sowie die Bedeutung der Impfung berücksichtigen.

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Authors and Affiliations

  1. Medical Corps, Israel Defence Force, P. O. Box 8145, 49181, Petah Tiqva

    R. Almog M. D., M. Gdalevich M. D., B. Lev M. D., M. Wiener M. D. & S. Ashkenazi M. D., M. Sc.

  2. Clinical Microbiology Unit, Hadasseh Hospital, P. O. Box 12000, 91120, Jerusalem, Israel

    C. Block M. B. B. Ch., Ph. D.

Authors
  1. R. Almog M. D.
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  2. M. Gdalevich M. D.
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  3. B. Lev M. D.
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  4. M. Wiener M. D.
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  5. S. Ashkenazi M. D., M. Sc.
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  6. C. Block M. B. B. Ch., Ph. D.
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Almog, R., Gdalevich, M., Lev, B. et al. First recorded outbreaks of meningococcal disease in the Israel Defence Force: Three clusters due to serogroup C and the emergence of resistance to rifampicin. Infection 22, 69–71 (1994). https://doi.org/10.1007/BF01739006

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  • DOI: https://doi.org/10.1007/BF01739006

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