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To the Editor.—The epidemiology of meningococcal disease in the United States and Europe is shaped by the functioning public health infrastructure. Sporadic small outbreaks and a total of about 2500 cases per year of invasive meningococcal disease occur in the United States.¹ In this circumstance the role of vaccine in reducing the incidence of meningococcal disease is often overlooked. However, in less developed regions the epidemiology of meningococcal disease is dramatically different, with episodic major epidemics and substantial mortality. Widespread vaccine use in these settings would have dramatic impact on morbidity and mortality. The best use of vaccine would be to vaccinate the population at risk before the onset of epidemic infection.

The subtitle of the Editorial by Drs Moore and Osterholm,¹ "Meningococcal Disease and Public Health Practice: A Complicated Road Map," suggests an important public health resource: maps. For example, recent studies indicate the utility of satellite geographic . . . [Full Text of this Article]

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RELATED ARTICLE

Meningococcal Disease and Public Health Practice: A Complicated Road Map
Kristine A. Moore and Michael T. Osterholm
JAMA. 1998;279(6):472-473.
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