The reasons are unknown why N. meningitidis, unlike Haemophilus influenzae and Streptococcus pneumoniae, is prone to cause epidemics of meningitis. Meningococcal meningitis can spread rapidly in crowded and stressed populations such as military recruits (figure 26.8). More typically, however, it appears at widely separate locations and occurs throughout the year. Humans are the only source of the infection, and transmission can occur with exposure to a person with the disease or an asymptomatic carrier of N. meningitidis. The majority of meningococcal infections are limited to the nose and throat and pass unnoticed. If a selective medium is used to suppress the growth of other nasopharyn-geal flora, meningococci can be recovered fTom the throats of 5% to 15% of apparently healthy people.

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