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Bacterial meningitis in the United States, 1978 through 1981. The National Bacterial Meningitis Surveillance Study
Abstract:
From 1977 to 1981, 18,642 cases of bacterial meningitis were reported to the Centers for Disease Control. We analyzed data from 27 states with full participation from 1978 through 1981. Hemophilus influenzae was the most frequent cause of bacterial meningitis (48.3%), followed by Neisseria meningitidis (19.6%) and Streptococcus pneumoniae (13.3%). Overall attack rates for males were greater than for females (3.3 v 2.6 cases per 10(5) population per year). Attack rates were highest in children under 1 year of age (76.7 per 10(5) population per year). Case-fatality ratios were highest for gram-negative and miscellaneous causes of bacterial meningitis (33.7%) and lowest for meningitis caused by H influenzae (6.0%). Neisseria meningitidis and S pneumonia meningitis occurred preponderantly during the winter, while H influenzae meningitis had peak activity in the spring and fall. Ampicillin resistance among H influenzae increased from 18.7% in 1978, to 23.9% in 1981. Serogroup B Neisseria meningitidis was the most common serogroup identified during the reporting period (51.1%), followed by serogroup C (22.3%), serogroup Y (5.8%), and serogroup A (4.7%) infections.
Insights
Bacterial meningitis surveillance data from 1978-1981 reveal Hemophilus influenzae as the leading cause, with highest attack rates in infants. Ampicillin resistance in H. influenzae increased, and specific pathogens showed seasonal patterns.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Bacterial meningitis remains a significant public health concern, necessitating ongoing surveillance to understand causative agents and trends.
- Data from the Centers for Disease Control (CDC) provide crucial insights into the epidemiology of bacterial meningitis in the United States.
Purpose of the Study:
- To analyze national surveillance data on bacterial meningitis from 1978 to 1981.
- To identify the most common pathogens, demographic risk factors, seasonal patterns, and antimicrobial resistance trends.
Main Methods:
- Retrospective analysis of reported bacterial meningitis cases from 27 participating states between 1978 and 1981.
- Calculation of attack rates, case-fatality ratios, and antimicrobial resistance patterns.
Main Results:
- Hemophilus influenzae was the predominant cause (48.3%), followed by Neisseria meningitidis (19.6%) and Streptococcus pneumoniae (13.3%).
- Highest attack rates were observed in children under 1 year of age, with males having higher overall rates than females.
- Ampicillin resistance in H. influenzae increased from 18.7% in 1978 to 23.9% in 1981. Serogroup B Neisseria meningitidis was most prevalent.
Conclusions:
- H. influenzae, N. meningitidis, and S. pneumoniae were the primary bacterial meningitis pathogens during the study period.
- Understanding pathogen-specific epidemiology and resistance patterns is crucial for effective prevention and treatment strategies.