PUBLIC HEALTH MANAGEMENT OF INCREASED INCIDENCE OF MENINGOCOCCAL DISEASE IN THE

This paper describes a sudden increase of mening- ococcal notifications in the Australian Capital Territory within a 3 month period, and the public health strategies used to manage it. There were 15 cases of meningococcal disease notified to the Communicable Disease Control (CDC) section, Australian Capital Territory Health (ACT Health), between 6 November 2003 and 5 February 2004. This was much higher than the annual average of 6 cases. The cases were notified in 2 clusters. The first cluster of 8 cases, all serogroup C, was noti- fied between 6 November to 8 December 2003. Seven of these cases had an identical phenotype C:2a:P1.4 suggesting a common source. The second cluster of 7 cases was notified between 30 December 2003 and 5 February 2004. Of these, 5 were serogroup B, 1 was serogroup W-135 and 1 was serogroup C, whose phenotype (C:2a:P1.4) was identical to the phenotype of the first cluster of serogroup C cases. Phenotypes were not avail- able for the serogroup B cases. There were 4 main interventions developed to manage the increased incidence based on the epidemiology of the cases; these were implemented concurrently. Factors that supported investigation and management were good surveillance systems, quick turnover of labo- ratory tests, regular communication with relevant health agencies and maintaining public awareness. As the number of cases notified was much higher than the annual average, the possibility of a com- munity outbreak was considered. The Guidelines for the Early Clinical and Public Health Management of Meningococcal Disease in Australia (national guidelines) were consulted to determine whether there was an outbreak and the influence this had on management is also discussed. Commun Dis Intell 2007;31:112-118.