An attempt at an epidemiological explanation - Epib.nl

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The researcb presented in tbis thesis was performed at the Institute for Researcb inExtramural Medicine (EMGO Institute) of the Vrije Universiteit, Amsterdam, TheNetherlands, tbe Netherlands Reference Laboratory for Bacterial Meningitis of theUniversity of Amsterdam and the National Institute for Public Health and EnvironmentalProtection, Amsterdam, The Netherlands, and the Unit of Bacterial VaccineDevelopment and Pathogenesis Researcb, National Institute for Public Health andEnvironmental Protection, Bilthoven, The Netherlands.This study was partially supported by a grant from the Praeventiefonds (no. 28-1874).The author is indebted to Brocades Pharma Nederland bv and Pasteur M6rieuxNederland, sera & vaccins, for financial support in the publication of this thesis.ISBN 90-9006178-9NUGI741Cover design: Mar van der Windt, Zutphen, The NetherlandsPrinting: CopyPrint 2000, Enschede, The Netherlands
VRIJE UNIVERSITEITTHE INCREASED INCIDENCE OFMENINGOCOCCAL DISEASE IN THE NETHERLANDS1980-1990An attempt at an epidemiological explanationACADEMISCH PROEFSCHRIFrter verkrijging van de graad van dactaraan de Vrije Universiteit te Amsterdam,ap gezag van de rectar magnificus dr. C. Datema,hoogleraar aau de faculteit def letteren,in het apenbaar te verdedigenten overstaan van de promotiecommissievan de faculteit der geneeskundeop vrijdag 11 juni 1993 te 15.30 uurin bet haafdgebauw van de universiteit,De Baelelaan 1105doorRobertus Johannes Pctrus Maria SchoItengebaren te Amsterdam
Page 1: An attempt at an epidemiological ex
Page 5 and 6: CONTENTSChapter 1 General introduct
Page 7 and 8: Chapter 1Meningococcal disease (MD)
Page 9 and 10: Chapter 1Antigenic variation in the
Page 11 and 12: Chapter 1by electrophoretic typing.
Page 13 and 14: Chapter 1is assumed to be the main
Page 15 and 16: CluJpter 1Study objectives and cont
Page 17 and 18: Chapter 125 Crowe BA. Wall RA. Kuse
Page 19 and 20: Chapter 170 Brandtzacg P, Kicrulf P
Page 21 and 22: Chapler 2ABSTRACfIn order to explai
Page 23 and 24: Chapter 2MATERIALS AND METHODSBacte
Page 25 and 26: Chapter 2Table 2. An nual number of
Page 27 and 28: Chapter 2the age-distribution to ol
Page 29 and 30: Chapter 2of serotype 4 strains vari
Page 31 and 32: Chapter 2Table 6. Relative distribu
Page 33 and 34: Chapter 2endemicity in the Netherla
Page 35 and 36: Chapter 2REFERENCESde Marie S. Epid
Page 37 and 38: CHAPTER 3PHENOTYPIC AND GENOTYPIC C
Page 39 and 40: Evolution of meningococcal cionesIN
Page 41 and 42: Evolution of meningococcal clonesme
Page 43 and 44: Evolution of meningococcal clonesTa
Page 45 and 46: Evolution of meningococcal clonesli
Page 47 and 48: CHAPTER 4LIPOOLIGOSACCHARIDE IMMUNO
Page 49 and 50: LOS immunotyping of N. meningitidis
Page 51 and 52: LOS immunotyping of N. meningitidis
Page 53 and 54:
LOS immunotyping of N. meningitidis
Page 55 and 56:
Page 57 and 58:
LOS immunolyping of N. meningilidis
Page 59 and 60:
LOS immunolyping of N. meningilidis
Page 61 and 62:
Page 63 and 64:
Page 65 and 66:
Chapter 5ABSTRACfThe aim of this pr
Page 67 and 68:
Chapter 5tive lung disease, chronic
Page 69 and 70:
Chapter 5distribution of the clinic
Page 71 and 72:
Chapter 5The striking difference in
Page 73 and 74:
Chapter 510-19 and ~50 years, in wh
Page 75 and 76:
Chapter 5REFERENCES1 Andersen BM. M
Page 77 and 78:
Chapter 6ABSTRACfObjectives: To ass
Page 79 and 80:
Chapter 6PATIENTS AND METHODSThis s
Page 81 and 82:
Chapler 6case. In 28 household cont
Page 83 and 84:
Chapter 6rifampicin witb oral contr
Page 85 and 86:
CHAPTER 7GENERAL DISCUSSION ANDRECO
Page 87 and 88:
General discussionexample of the ab
Page 89 and 90:
General discussionPossible changes
Page 91 and 92:
General discussionBrazilian study,
Page 93 and 94:
General discussionIt is very diffic
Page 95 and 96:
General discussionREFERENCES1 Pelto
Page 97 and 98:
SUMMARY
Page 99 and 100:
Summaryemergence of a meningococcal
Page 101 and 102:
Summaryexplains part of the rise. T
Page 103 and 104:
SamenvattingMeningokokkenziekte (me
Page 105 and 106:
Samenvatting57 isolaten was bet imm
Page 107 and 108:
AFFILIATIONS OF CO-AUTHORSHenk A. B
Page 109 and 110:
DaJl /..:woordVele" hebben meegewer
Page 111:
DanklVoordMijD ouders dank ik voor
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