The current serotyping system for meningococci is based on a battery of Mabs which recognize antigenic differences in the outer membrane proteins of class 2 or 3 and 1, respectively. In greater São Paulo, there has been a constant increase in the incidence of serogroup C meningococcal disease since the late 1980s. Serotype 2b isolates were responsible for most of this increase, representing approximately 22 and 74% of the serogroup C strains isolated in 19, respectively. In that region, the prevalence of serogroup C strains increased from 4 to 14% and 8 to 32% during the years 19, respectively. The incidence of MD caused by Neisseria meningitidis serogroup C in greater São Paulo has been low since the end of the epidemic situation in 19. This epidemic differed from previous ones because it was caused by serogroup B strains in 19 and serogroup B and C strains in 1990. In 1988, the incidence of MD in the greater Sao Paulo area exceeded 4.06 per 100,000 inhabitants, suggesting a new epidemic in that region. During the period between 19, the mean proportion of serogroup B isolates identified was about 83%, while serogroup C strains represented only 6% of isolates. From 1980 to 1992, the annual incidence of MD ranged from 1.0 to 1.4 per 100,000 inhabitants in different states of Brazil. In 1974, the incidence was greater than 179 cases per 100,000 inhabitants. The incidence of MD in Brazil has been monitored since the occurrence of serogroup A and C epidemics between 19. Meningococcal disease (MD) is a significant cause of mortality and morbidity throughout the world.
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