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Annual report National Notifiable Diseases Surveillance System, 2004
Figure 66. Notification rates of meningococcal C
infection, Australia, 2000 to 2004, by age group
Rate per 100,000 population
5
4.5
4
3.5
3
2.5
2
1.5
1
0.5
0
2000 2001 2002 2003 2004
Year of onset
Data on deaths from meningococcal infection were
available for 172 (42%) cases. There were 20 deaths
due to meningococcal infection in 2004 giving a
crude case fatality rate of 5 per cent. The breakdown
of deaths by jurisdiction and serogroup are shown
in Table 26. The case fatality rate of 5.4 per cent
for infections with meningococcal group C was the
same as that for meningococcal group B infections.
In 2003, the case fatality rate for infections with
meningococcal group C was more than three times
higher than for meningococcal group B infections. 47
Laboratory based meningococcal surveillance
The Australian Meningococcal Surveillance
Programme was established in 1994 for the purpose
of monitoring and analysing isolates of Neisseria
meningitidis from cases of invasive meningococcal
disease in Australia. The program is undertaken by
a network of reference laboratories in each state
and territory, using agreed standard methodology to
determine the phenotype (serogroup, serotype and
serosubtype) and the susceptibility of N. meningitidis
to a core group of antibiotics. The results of the surveillance
in 2004 have recently been published. 48
0-4
5-9
10-14
15-19
20-24
25-29
Consistent with routine surveillance data, serogroup
B continued to be the predominant strain for
the disease (243 isolates, 67%) nationally, followed
by serogroup C (71 isolates, 20%). Serogroup B
strains predominated in all jurisdictions except the
Australian Capital Territory where 8 of 11 isolates
were serogroup C.
The pattern of age distribution for meningococcal
infection varied by phenotype. Serogroup B was
more frequently reported in the 5–9 year (90.5%)
and 0–4 year (87.4%) age groups, while the largest
proportions of serogroup C occurred in the
25–44 year (35.7%), and 20–24 year (31.4%) age
groups. This represents a shift in the age distribution
of both serogroups from 2003 when most infections
with serogroup B occurred in the 0–4 year age
group, and serogroup C infections were reported
most frequently in the 15–19 year age group.
In 2004, 147 of the 238 isolates (62%) tested showed
decreased susceptibility to the penicillin group of
antibiotics (MIC 0.06–0.5 mg/L). All isolates tested
were susceptible to third generation cephalosporins
and the prophylactic antibiotics, ciprofl oxacin and
rifampicin.
Tuberculosis
Case defi nition – Tuberculosis
Only confirmed cases are notifi ed.
Confirmed case: Defi ned as of Mycobacterium
tuberculosis complex by culture, OR detection
of M. tuberculosis complex by nucleic acid
testing except which it is likely to be due to
previously treated or inactive disease OR clinical
diagnosis of tuberculosis including clinical
follow-up assessment to ensure a consistent
clinical course.
In 2004, a total of 361 isolates of N. meningitidis were
analysed by the program, a 27 per cent decrease
from the 494 isolates analysed in the previous year.
Table 26. Deaths due to meningococcal infection, Australia, 2004, by state or territory and serogroup
Species State or territory Total
ACT NSW NT Qld SA Tas Vic WA
Serogroup B 0 4 0 1 1 1 5 1 13
Serogroup C 0 1 0 1 0 1 1 0 4
Other serogroups* 0 0 0 1 0 0 0 1 2
Unknown serogroup 0 1 0 0 0 0 0 0 1
Total 0 6 0 3 1 2 6 2 20
* Other includes serogroups A, Y and W135.
72 CDI Vol 30 No 1 2006