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The clinical features of paediatric meningococcal disease Auckland, 1985-87
1Princess Mary Hospital, Auckland.
Abstract:
An epidemic of group A meningococcal disease began in Auckland in May 1985. There were 122 paediatric cases of meningococcal disease in the next 25 months including 98 cases due to group A. The commonest clinical symptoms were vomiting, headache and photophobia, while frequent signs included fever, seizures, petechial rash and meningism or a bulging fontanelle. Complications were uncommon and included sterile arthritis and prolonged fever. The majority had disease confirmed by positive blood or cerebrospinal fluid culture. Significantly fewer positive cultures were seen in those treated with antibiotics prior to admission. The overall mortality was 7%. If the acute illness was survived, the only detected long term sequela was sensorineural hearing loss seen in 6%. A vaccine programme has been undertaken to control this epidemic.
Insights
A group A meningococcal disease epidemic in Auckland pediatric patients caused 122 cases over 25 months. The disease had a 7% mortality rate, with sensorineural hearing loss as the main long-term effect.
Area of Science:
- Epidemiology
- Infectious Diseases
- Pediatrics
Background:
- A significant epidemic of group A meningococcal disease occurred in Auckland, New Zealand, starting in May 1985.
- This epidemic primarily affected the pediatric population over a 25-month period.
Purpose of the Study:
- To describe the clinical characteristics, complications, and outcomes of pediatric group A meningococcal disease during the Auckland epidemic.
- To evaluate the impact of pre-admission antibiotic treatment on culture positivity.
- To inform public health interventions, including a vaccine program.
Main Methods:
- Retrospective review of 122 pediatric cases of meningococcal disease.
- Analysis of clinical symptoms, signs, complications, and mortality.
- Comparison of culture positivity rates between patients with and without pre-admission antibiotic treatment.
Main Results:
- 98 of 122 cases were attributed to group A meningococcal disease.
- Common symptoms included vomiting, headache, and photophobia; frequent signs were fever, seizures, and rash.
- Overall mortality was 7%, with sensorineural hearing loss observed in 6% of survivors. Pre-admission antibiotics significantly reduced positive culture rates.
Conclusions:
- Group A meningococcal disease posed a substantial threat to children during the Auckland epidemic, characterized by specific clinical presentations and a notable mortality rate.
- While complications were infrequent, sensorineural hearing loss was a significant long-term sequela.
- The findings underscore the importance of diagnostic accuracy, timely treatment, and vaccination programs for controlling meningococcal disease outbreaks.