Background Few posted reports have evaluated the clinical features and outcome of serogroup W135 meningococcal disease. associated with death, three independent factors were found: bacteremia without meningitis, altered mental status, and petechiae or purpura on admission. Conclusion Sporadic serogroup W135 meningococcal disease is an important component of the meningococcal disease burden in Taiwan, but it is not associated with Hajj pilgrims directly. Weighed against patients contaminated by additional serogroups of meningococci, individuals with serogroup W135 had been older and much more likely to possess extrameningeal involvement such as for example pneumonia. Background Earlier studies of meningococcal disease in america and elsewhere discovered serogroup W135 was uncommon [1]. An outbreak of serogroup W135 meningococcal disease in buy Phenoxybenzamine HCl Saudi Arabia following a 2000 Hajj was reported, and pass on to many countries all over the world [2-4] then. Higher carriage price of N Significantly. meningitidis serogroup W135 in pilgrims coming back through the Hajj [5,6] and carrying on diversification from the serogroup following its introduction in 2000 continues to be discovered [7,8]. In Taiwan, no more than 2% (50,000) of the populace buy Phenoxybenzamine HCl are Muslims. In the time from 2001 through 2003, about 20 to 40 pilgrims each year proceeded to go from Taiwan to Saudi Arabia for the Hajj (data from Chinese language Muslim Association, Taiwan). Small is well known about the medical features and result of serogroup W135 disease [9-11], but there are some reports of extrameningeal complications [11-13]. The incidence of meningococcal disease in Taiwan was below 0.001 from 1980 to 1987, and re-emerged in 2000 with a rate of 0.07/105 population. In 2001 there was a further increase in incidence (0.19/105) [14]. Serogroup B was the most common and W135 was secondmost predominant, which is different from other country [1,14]. To determine the clinical characteristics and outcome of patients with serogroup W135 and non-W135 meningococcal disease in Taiwan, a nationwide study was conducted from January 1, 2001, through December 31, 2003. The relationship between N. meningitidis serogroups with respect to patient characteristics, clinical manifestations, and outcome was assessed. The factors associated with mortality in meningococcal disease were also buy Phenoxybenzamine HCl investigated. Strategies Case microbiology and reporting lab techniques In the Country wide Notifiable Disease Security Program in Taiwan, patients with unexpected starting point of fever, headaches, nausea, vomiting, stiff throat, petechial allergy with red macules, followed by delirium, coma or shock; or Gram-negative diplococci were found in smear of cerebrospinal fluid by Gram-stain should be reported to the Center for Disease Control (CDC), Taiwan as suspected cases of invasive meningococcal disease within 24 hours. In addition to the routine examination and culture in individual hospital, blood and/or cerebrospinal fluid of the suspect N. meningitidis would be sent to the bacteriology laboratory of Taiwan CDC at room temperature as soon as possible for bacteria culture and serogrouping. If N. meningitidis is usually isolated and the patient Rabbit polyclonal to AnnexinA11 had compatible clinical symptoms and signs, the patient would be justified as a confirmed case of invasive meningococcal disease. If N. meningitidis is usually isolated in bacteriology laboratory of individual hospital, the isolate would be sent to Taiwan CDC laboratory. The identification of all isolates were reconfirmed at Taiwan CDC using conventional biochemical methods [15]. Serogrouping using the agglutination test (Murex Biotech Ltd, Dartford, UK) and standard grouping sera for capsular types A, B, C, X, Y, Z, and W-135 was also performed at Taiwan CDC. Epidemiological investigation Within 48 hours since suspected case reported, the staffs at local Health Bureau will conduct the case investigation, to understand the detail travel history and identify every single close contact during the 2 weeks before disease onset. Patients or their family who have traveled abroad 3 months before onset were recorded. If any close contact develops fever, the person would be send to hospital immediately for examination, sampling and treatment. The close contacts with no related symptoms would receive prophylaxis as soon as possible. Clinical information collection From January 2001 through December 2003, case-record forms designed for collection of detailed clinical data were send to and filled out by those physicians who.