Objective: To describe a Neisseria meningitidis outbreak in Gauteng during the period 1 July to 31 December 1996.
Design: A descriptive study.
Setting: Patients with meningococcal meningitis in Gauteng who had been diagnosed by laboratory means, or notified during the period 1 July to 31 December 1996.
Main outcome measures: Data including age, sex, date of admission to hospital, N. meningitidis serogroup and outcome were collected from Gauteng notification lists, South African Institute of Medical Research (SAIMR) records, a linelist compiled by the Gauteng Health Department, and hospital records.
Results: A total of 201 patients was studied; of this number 87 (43%) had been notified. Seventy per cent of cases were below 30 years of age and 78% were male. More than half (54%) of the cases were from the West Rand. The case fatality rate for 70 cases of known outcome was 14%. Serotyping of 85 isolates showed that a majority (76%) were serogroup A, with 57% being serogroup A clone I-1. Serogroup A clone III-1 accounted for 14% of the typed isolates. All isolates were sensitive to penicillin with minimum inhibitory concentrations of < 0.05 microgram/ml.
Conclusion: In 1996 Gauteng experienced an epidemic of serogroup A meningococcal meningitis. The serotype that caused the majority of cases had been recorded in South Africa before, but serogroup A clone III-1, responsible for epidemics spreading across two continents, was recorded in South Africa for the first time. Notification of cases by health workers was inadequate in this epidemic.