Meningococcal infection in previously A-C vaccinated pilgrims

Objective: To study the profile of meningococcal infection among pilgrims who had previous A-C vaccination. Setting: King Abdul Aziz Hospital, Madinah Al-Munawarah, Saudi Arabia. Subjects and Methods: Fifteen patients with documented A-C vaccination admitted to the above hospital during the study period of April 1992 to June 1993 with meningococcal infection were evaluated prospectively regarding their clinical and laboratory features, culture and antibiotic sensitivity and meningococcal serotypes. Results: Twelve cases presented as meningitis while three cases had meningococcaemia. Most (53.3%) were from Pakistan while the rest were from 6 other countries. Clinical and laboratory features at presentation were similar as reported in the literature. In 13 cases where serotyping could be done, most belonged to group A (54%) and C (23%). Anti-microbial sensitivity showed the isolates to be sensitive to most of the antibiotics commonly used to treat this infection. Mortality was 33% with the poorest outcome in patients with W135 infection. Conclusion: This study underscores the need of further studies in Makkah and Madinah, Saudi Arabia to find out the serotypes and immunological factors responsible for meningococcal infection in A-C vaccinated pilgrims so as to explore the possibility of use of polyvalent meningococcal vaccine.