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Published on: November 5, 2019
Epidemiology of bacterial meningitis in the North American Arctic, 2000-2010
Prabhu P Gounder1, Tammy Zulz1, Shalini Desai2
1Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA.
Objective:
To determine the incidence of meningitis caused by Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae in the North American Arctic during 2000-2010.
Methods:
Surveillance data were obtained from the International Circumpolar Surveillance network. We defined a case of bacterial meningitis caused by H. influenzae, N. meningitidis, or S. pneumoniae as a culture-positive isolate obtained from a normally sterile site in a resident with a meningitis diagnosis.
Results:
The annual incidence/100,000 persons for meningitis caused by H. influenzae, N. meningitidis, and S. pneumoniae among all North American Arctic residents was: 0.6, 0.5, and 1.5, respectively; the meningitis incidence among indigenous persons in Alaska and Canada (indigenous status not recorded in Greenland) for those three bacteria was: 2.1, 0.8, and 2.4, respectively. The percentage of pneumococcal isolates belonging to a 7-valent pneumococcal conjugate vaccine serotype declined from 2000-2004 to 2005-2010 (31%-2%, p-value <0.01). During 2005-2010, serotype a caused 55% of H. influenzae meningitis and serogroup B caused 86% of meningococcal meningitis.
Conclusions:
Compared with all North American Arctic residents, indigenous people suffer disproportionately from bacterial meningitis. Arctic residents could benefit from the development of an H. influenzae serotype a vaccine and implementation of a meningococcal serogroup B vaccine.
Insights
Indigenous Arctic residents experience higher rates of bacterial meningitis caused by Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae. Targeted vaccine development for H. influenzae serotype a and N. meningitidis serogroup B is recommended.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Bacterial meningitis remains a significant public health concern in the Arctic.
- Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae are key causative agents of bacterial meningitis.
Purpose of the Study:
- To determine the incidence of meningitis caused by H. influenzae, N. meningitidis, and S. pneumoniae in the North American Arctic from 2000-2010.
- To compare meningitis incidence between indigenous and non-indigenous populations in the region.
Main Methods:
- Utilized surveillance data from the International Circumpolar Surveillance network.
- Defined bacterial meningitis cases based on culture-positive isolates from sterile sites in individuals with a meningitis diagnosis.
Main Results:
- Overall annual incidence per 100,000 persons was 0.6 for H. influenzae, 0.5 for N. meningitidis, and 1.5 for S. pneumoniae.
- Indigenous populations in Alaska and Canada showed higher incidences: 2.1 for H. influenzae, 0.8 for N. meningitidis, and 2.4 for S. pneumoniae.
- A significant decline in vaccine-preventable pneumococcal serotypes was observed, while H. influenzae serotype a and N. meningitidis serogroup B were predominant in later years.
Conclusions:
- Indigenous people in the North American Arctic experience a disproportionately high burden of bacterial meningitis.
- Development of vaccines targeting H. influenzae serotype a and N. meningitidis serogroup B could significantly benefit Arctic residents.
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