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Neisseria meningitidis remains a serious bacterial threat to the well-being of children. Since the introduction of immunization against Haemophilus influenzae and Streptococcus pneumoniae, the risk of serious illness from these organisms has decreased sharply among immunized children, and it is hoped that widespread use of meningococcal conjugate vaccine will lead to the same outcome. The meningococcus causes a variety of disease entities, but this review focuses primarily on its two major manifestations: severe meningococcal septicemia (SMS), sometimes confusingly called “meningococcemia,” and meningococcal meningitis (MM).

Annually, meningococcal disease has affected as many as 3,000 people in the United States. Although outbreaks of illness tend to receive major media attention, fewer than 5% of cases occur during outbreaks. The prevalence of the asymptomatic carrier state varies from less than 2% in children younger than 2 years of age to as high as...

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