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Pneumococcal meningitis and bacteraemia in Danish children 1969-1978. Serotypes, incidence and outcome
Insights
Pneumococcal meningitis affected 2.1 per 100,000 Danish children annually (1969-1978), primarily those under two. Common serotypes like 14 and 18C were identified, informing vaccine development.
Area of Science:
- Pediatrics
- Infectious Diseases
- Epidemiology
Background:
- Pneumococcal meningitis and bacteremia pose significant risks to children.
- Understanding the epidemiology of pneumococcal infections is crucial for public health strategies.
Purpose of the Study:
- To estimate the incidence and mortality of pneumococcal meningitis and bacteremia in Danish children.
- To identify the most prevalent pneumococcal serotypes causing invasive disease in this population.
- To assess the sequelae associated with these infections.
Main Methods:
- Retrospective analysis of pediatric cases of pneumococcal meningitis and bacteremia in Denmark (1969-1978).
- Collection and serotyping of Streptococcus pneumoniae isolates from cerebrospinal fluid and blood samples.
- Calculation of incidence rates, mortality rates, and assessment of long-term sequelae.
Main Results:
- The incidence of pneumococcal meningitis was 2.1 per 100,000 children (0-14 years).
- Children under two years old represented the majority of cases (55% for meningitis, 61% for bacteremia).
- Mortality rates were 13% for meningitis and 7% for bacteremia; 14% of meningitis survivors had sequelae.
- Serotypes 14, 18C, 6A+6B, 23F, 7F, and 19F were the most common, accounting for 69% of isolates.
Conclusions:
- Pneumococcal meningitis and bacteremia disproportionately affect young children, with notable mortality and morbidity.
- The identified prevalent serotypes are critical for evaluating the effectiveness of current and future pneumococcal vaccines.
- These findings underscore the importance of serotype surveillance in guiding vaccination policies.
Abstract:
The incidence of pneumococcal meningitis in Danish children during 1969-1978 was estimated to be 2.1/year/100,000 children from 0 to 14 years old. Fifty-five per cent of 146 children with pneumococcal meningitis and 61% of 61 with bacteraemia were below 2 years of age. Mortality from meningitis was 13% and from bacteraemia 7%. Of the children with meningitis, 14% had sequelae at the time of discharge from the hospital. Sequelae were not seen after bacteraemia. Among 277 pneumococcal isolates from spinal fluid and blood from Danish children during 1969-1978, serotypes 14, 18C, 6A + 6B, 23F, 7F and 19F, in that order of frequency, were the most common ones, accounting for 69% of all isolates. Serotypes included in current 14-valent pneumococcal polysaccharide vaccines made of 80% of all types, when types 6A and 6B are considered together (because it has been shown that they offer cross-protection).