An epidemic of group B meningococcal disease on the Faroe Islands is described. A peak annual incidence of 95 cases/100,000 was reached in 1981. The time at which the epidemic commenced cannot be determined due to inadequate diagnostic facilities, but was presumably around the end of the 1970s. The incidence fell to 29 cases/100,000 in 1985, which indicates that the Faroe Islands are still a high incidence area. A total of 203 cases of meningococcal disease were recorded during the period 1978-1985 with 11 deaths (lethality rate 5.4%). After rifampicin was introduced in 1981 as prophylactic treatment against secondary cases, 1,892 persons were treated with this agent and none of these appeared in the study population. Before rifampicin prophylaxis was introduced, the number of cases were distributed with an evenly increasing incidence in the capital and in the provinces. Following the introduction of rifampicin as prophylactic agent, a fall in the incidence in both areas was observed. This fall was more pronounced in the capital, where the number of prescribed prophylactic doses per case of meningococcal disease was higher than in the province.

Pedigree studies were performed based on one Faroese and four Danish probands with overt idiopathic hemochromatosis (IH). The study consisted of HLA typing and determination of biochemical iron status indicators (serum transferrin saturation, serum ferritin). In total, 130 persons were evaluated. The screening identified 6 homozygous (h/h) subjects with preclinical IH, 46 heterozygous (h/n), and 8 normal (n/n) subjects, while 39 subjects were classified as normal or heterozygous (n/h?). One family demonstrated both a homozygous x heterozygous as well as a heterozygous x heterozygous mating. Recombination between the HLA region and IH locus occurred possibly in three subjects in three different families. The significance of detailed screening in families with probands with IH is discussed.

The accuracy (sensitivity and positive predictive value) of the clinical diagnosis given by the general practitioner before admission to hospital was evaluated retrospectively in a population with epidemic meningococcal disease. The study population consisted of approximately 32,000 subjects. In a 12-year period, 344 patients were discharged from hospital with CNS infections, 274 of whom were admitted with a diagnosis suspecting a CNS infection. A further 401 patients were admitted with suspicion for, but discharged without a CNS infection. Overall, the sensitivity was 79.7% and the positive predictive value was 40.6%. There were no significant changes in the accuracy during the study. The sensitivity differed significantly between the age groups (P less than 0.001) and was lowest among the adults (15+ years, 67.9%) and the 0-2-year-old children (72.7%). Also among the 0-2 year-olds, the positive predictive value was low (34.1%) and not significant, indicating that it was more difficult to obtain the correct clinical diagnosis in this group.

Iron status (haemoglobin, S-ferritin, S-iron, S-transferrin, and transferrin saturation) was evaluated in an epidemiological survey comprising a representative sample of 118 (4%) of the 40- to 49-year-old Faroese male population. All had normal haemoglobin, (mean +/- SD 153 +/- 9 g/l; 9.5 +/- 0.6 mmol/l). Median S-ferritin was 151 micrograms/l, 5-95 percentile 46-588 micrograms/l, observed range 33-1166 micrograms/l. None had depleted iron stores (S-ferritin less than or equal to 20 micrograms/l), 2.5% had 'small' iron stores (S-ferritin 21-40 micrograms/l), 80.5% had 'normal' iron stores (S-ferritin 41-300 micrograms/l) and 17% had 'increased' iron stores (S-ferritin greater than 300 micrograms/l). Transferrin saturation values were greater than 16% in all males; high values greater than 50% were found in 9.3%, and the combination of high transferrin saturation and S-ferritin greater than 300 micrograms/l was found in 3.4% of the males. Median P-ascorbic acid was 26 mumol/l, 5-95 percentile 7-67 mumol/l; significantly higher in subjects taking vitamin supplements (n = 35, median 50 mumol/l) than in those not taking supplements (n = 81, median 23 mumol/l) (p less than 0.0001). There was no correlation between P-ascorbic acid and iron status markers. The results indicate a high frequency of ample iron reserves in the Faroese male population.