Meningococcal disease and season in sub-Saharan Africa.

The incidence of meningococcal disease varies seasonally in both tropical and temperate countries. This association is most apparent in sub- Saharan Africa, where almost all epidemics start in the dry season and abate during the rains . Meningococcal carriage rates do not vary with season either in Africa or in temperate countries, suggesting that seasonal factors have little influence on the frequency of meningococcal transmission. It is suggested that changes in the ratio of clinical to subclinical cases of infection are more important than changes in the frequency of transmission in producing seasonal variations in the incidence of meningococcal disease. Some evidence to support this hypothesis was obtained during an epidemic of group A meningococcal disease in northern Nigeria in 1977-79.