Respiratory Viruses and Mycoplasma as Cofactors for Epidemic Group A Meningococcal Meningitis

doi:10.1001/jama.1990.03450100061026

Respiratory Viruses and Mycoplasma as Cofactors for Epidemic Group A Meningococcal Meningitis

From the Meningitis and Special Pathogens Branch, Division of Bacterial Diseases (Drs Moore and Broome and Messrs DeWitt and Plikaytis), and the Respiratory and Enteric Viruses Branch, Division of Viral and Rickettsial Diseases (Dr Hierholzer), Centers for Disease Control, Atlanta, Ga; Hôpital Central, N'Djamena, Chad (Mr Gouan and Dr Djoré); and the Harvard Institute for International Development, Cambridge, Mass (Dr Lippeveld). Dr Moore is now with the Center for AIDS Prevention Studies, University of California, San Francisco.

Abstract

To investigate the role of coincident respiratory viral and mycoplasmal agents in the pathogenesis of meningococcal meningitis, we performed a matched case-control study of 62 patients with group A meningococcal meningitis during an epidemic in Chad. Case patients were more likely than controls to have nasal colonization or infection with respiratory viruses and Mycoplasma species (matched odds ratio, 23; 95% confidence interval, 3.1 to 170). Respiratory pathogens were found more commonly in older patients with meningitis (odds ratios were 2.9 for children under age 5 years and 46.5 in those over age 15 years), consistent with the increasing risk of meningitis with age during epidemics. In controls, the presence of respiratory pathogens increased the risk of upper-respiratory-tract symptoms but did not significantly increase meningococcal carriage.

(JAMA. 1990;264:1271-1275)

Footnotes

Deceased.
Use of trade names is for identification only and does not imply endorsement by the US Public Health Service or by the US Department of Health and Human Services.
Reprint requests to Meningitis and Special Pathogens Branch, Division of Bacterial Diseases, Centers for Disease Control, Atlanta, GA 30333 (Dr Broome).