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Meningococcal disease among children who live in a large metropolitan area, 1981-1996

V J Wang1, N Kuppermann, R Malley

  • 1Emergency Medicine, Department of Medicine, Children's Hospital Boston, USA. wang@chla.usc.edu

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|March 27, 2001
PubMed

Insights

Pediatric meningococcal infections, caused by Neisseria meningitidis, were studied in Boston. While devastating for some, the overall disease burden in children was limited, with meningitis being the most common presentation.

Area of Science:

  • Pediatric infectious diseases
  • Bacteriology
  • Epidemiology

Background:

  • Neisseria meningitidis is a significant cause of severe pediatric bacterial infections.
  • Understanding the epidemiology and clinical spectrum of meningococcal disease in children is crucial for public health.

Purpose of the Study:

  • To determine the burden and spectrum of invasive meningococcal infections in children.
  • To describe the clinical manifestations and outcomes of pediatric meningococcal disease.

Main Methods:

  • Retrospective review of medical records for children under 18 years old.
  • Inclusion criteria: confirmed Neisseria meningitidis infection of blood, cerebrospinal fluid, or both.
  • Study period: 1981-1996 in Boston, Massachusetts.

Main Results:

  • 231 pediatric patients identified with meningococcal disease.
  • 194 (84%) had overt disease; 37 (16%) had unsuspected disease.
  • Meningitis (150 patients), hypotension (26), and purpura (17) were key clinical findings. Mortality rate was 7% (16 deaths).

Conclusions:

  • Pediatric meningococcal disease burden in this Boston cohort was limited.
  • Overt cases predominantly presented as meningitis.
  • Unsuspected meningococcal disease is rare in individual pediatric practice.

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