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Muscat M et al. – The findings underscore the importance of enhancing laboratory surveillance of the disease, including characterization of the meningococci. Until vaccines against a broad range of serogroup B meningococci become available for universal use, the main methods of control remain the early treatment of cases and the prevention of secondary cases.


Exclusive Author Commentary
Mark Muscat, 10/21/09

Since the mid-90s, meningococcal disease has acquired prominence on the island country of Malta on account of its resurgence after three decades of negligible reported cases. This article describes the epidemiology of the disease in Malta between 1994 and 2007. 233 cases were notified during this period. The upsurge of the disease became noticeable in 1996, placed Malta amongst countries with the highest incidence for the disease in Europe during the same period. The average age of the notified cases was 14 years and 165 (70%) were below 20 years of age. The disease claimed the lives of 28 patients giving an overall case fatality rate of 12%. Collectively, the number of cases peaked in late winter/early spring and again in summer. This is unlike the seasonal pattern observed in other European countries where the disease occurs mostly in winter. Laboratory investigations carried out on 114 cases showed that in Malta, serogroup B formed the largest proportion (76%) as in the rest of Europe, followed by serogroup C (16%). A particular strain of serogroup B identified as B:4:P1.19,15 has dominated Malta during the study period. The eventual development of a safe and effective vaccine against serogroup B strains for universal use would be a major public health tool to control meningococcal disease in Malta. Until then, the main methods of control remain the early treatment of cases and the prevention of secondary cases. The latter public health measures primarily involve the identification of close contacts and the administration of appropriate antibiotics.

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