Epidemic Meningitis in Naval Recruits

Abstract

Between 25 Jan. and 22 June 1963, 32 cases of meningococcal disease, including 3 deaths, occurred in recruits at a large Naval Training Center in San Diego, Calif. Over 80% of the clinical cases occurred in recruits who had been on the center less than 5 weeks. None of the training cadre and other permanent personnel at the base were affected. This outbreak was unusual because the predominant etiological agent was a strain of group B meningococci shown to be resistant to sulfadiazine (as well as increased resistance to pencillin and the tetracyclines) both in vitro and in vivo as demonstrated by studies on groups of recruit carriers. Mass administration of various chemotherapeutic agents to the population at risk in order to prevent new cases was of only questionable value. Control of the epidemic was finally achieved by temporarily halting the input of new recruits and by implementation of strict environmental control measures, which included the administration of sulfadiazine to all incoming recruits and the removal of all permanent personnel, if they were found to be N. meningitidis carriers, from contact with recruits. The recruit carrier rate was reduced from a high of 46% during the height of the epidemic to less than 2%.