Meningococcal disease at the University of Southampton: outbreak investigation.

In October 1997, an outbreak of meningococcal disease occurred at the University of Southampton. All six cases were first year students living in halls of residence. Microbiological characterization of case and carrier strains, case interviews, and a meningococcal carriage prevalence survey were used to investigate the outbreak. Five cases were due to serogroup C strains, one case was unconfirmed. Serotyping did not distinguish between the strains but gene sequencing permitted identification of two distinct strains in the outbreak. Although none of the cases was known to each other, three had attended the same nightclub one evening 3-4 days before illness. Meningococcal carriage rates in undergraduates were within the range expected (147/587, 25%), but no carriers of outbreak strains were identified in this sample. The findings suggest that in communities with a high degree of social interaction, the introduction of highly virulent meningococcal strains may result in enhanced transmission with clustering of cases.