American Journal of Epidemiology Vol. 143, No. 6: 624-630
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Outberak of Serogroup C Meningococcal Disease Associated with Campus Bar Patronage
1Department of Medical Information Science, College of Medicine at Urbana-Champaign; Department of Community Health, College of Applied Life Studies; and Department of Statistics, College of Liberal Arts and Sciences, University of Illinois Urbana, IL
2Childhood and Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention Atlanta, GA
3Current affiliation: Department of Epidemiology, School of Public Health and Community Medicine, University of Washington Seattle, WA
4Champaign-Urbana Public Health District Champaign, IL
5Department of Internal Medicine, College of Medicine at Urbana-Champaign, University of Illinois Urbana, IL
6McKinley Health Center, University of Illinois Urbana, IL
7Current affiliation: A. P. Beutel Student Health Center, Texas A & M University College Station, TX
Reprint requests to Dr. Peter B. Imrey, University of Illinois, 190 Medical Sciences Building, 506 South Mathews Avenue, Urbana, IL 61801–3669.
Between February 1991 and April 1992, eight undergraduates at a US residential university and one at a nearby 2-year college contracted serogroup C meningococcal disease. A case-control investigation with 20 controls per case, oropharyngeal carriage surveys, and multilocus enzyme electrophoresis (MEE) of serogroup C isolates were used to identify factors contributing to the outbreak. All eight sterile-site isolates from cases were closely related by MEE and were similar (though not identical) to the strain associated with the 1991–1992 epidemic of meningococcal disease in eastern Canada. Disease was associated with cigarette smoking (p = 0.012), recent patronage of campus-area bars (p = 0.034), estimated amount of time spent in campus-area bars (p = 0.0003), and, especially, recent patronage of one specific bar, bar A (p = 0.0006; odds ratio = 23.1, 95% confidence interval 3.0–571.5). In carriage surveys, 1, 528 throat cultures taken from (primarily student) noncases yielded only five (0.3%) strains that were identical by MEE to those from cases. Two of these were found among 22 cultures obtained from bar A employees in spring 1992. Some cases in this outbreak may have followed transmission of the epidemic strain in bar A. Campus bar environments may facilitate the spread of meningococcal disease among teenagers and young adults.
alcohol drinking; case-control studies; disease outbreaks; meningococcal infections; Neisseria meningitidis; smoking; social environment; students
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