Epidemiology and Risk Factors for Serogroup X Meningococcal Meningitis during an Outbreak in Western Kenya, 2005–2006

David M. Mutonga Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Guillermo Pimentel Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Judith Muindi Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Charles Nzioka Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Julius Mutiso Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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John D. Klena Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Myriam Morcos Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Thomas Ogaro Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Sadiki Materu Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Christopher Tetteh Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Nancy E. Messonnier Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Robert F. Breiman Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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Daniel R. Feikin Field Epidemiology and Laboratory Training Program – Kenya, Centers for Disease Control and Prevention and Kenya Ministry of Public Health and Sanitation, Nairobi, Kenya; US Naval Medical Research Program 3, Cairo, Egypt; Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya; African Medical Research Foundation, Nairobi, Kenya; Meningitis Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; International Emerging Infections Program, Kenya, Centers for Disease Control and Prevention, Nairobi, Kenya

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The epidemiology of serogroup X meningococcal meningitis in Africa is unknown. During a serogroup X meningococcus outbreak in Kenya, case finding involved record review at health facilities and interviews with health workers and community leaders in West Pokot district. An age- and location-matched case-control study for risk factors was done. From December 2005 to April 2006, 82 suspect cases of meningitis were reported; the epidemic threshold was surpassed within two administrative divisions. Most (58%) cases were 5–24 years old; the case-fatality ratio was 21%. Serogroup X meningococcus was the most common serogroup – 5 (63%) of eight isolates serogrouped. Living in the same compound as another case, preceding upper respiratory tract infection and cooking outside the house were significant risk factors for disease. Serogroup X meningococcus caused an outbreak with similar epidemiology and risk factors as other serogroups. Serogroup-specific laboratory-based surveillance for meningococcus in Africa to detect serogroup X disease should be enhanced.

Author Notes

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