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Meningococcal disease in childhood--a regional study in Ireland
Abstract:
A retrospective study of microbiology laboratory records of culture-confirmed cases of meningococcal disease in children under 14 years of age, admitted to four Dublin hospitals, was conducted for the period 1981-1991 inclusive. The study aimed to describe the epidemiology of meningococcal disease in childhood and to assess the potential of meningococcal group A and C vaccine in preventing disease. There were 406 cases of meningococcal disease of which 319 (78.6%) were in children under 5 years of age. The meningitis to septicaemia ratio was almost 4:1 (320 vs. 86 cases). Of the 406 cases, 216 (53.2%) cases occurred during the period November to March. The age-specific annual incidence rates for the Eastern Health Board region served was 64.2 per 100,000 under 1 year of age and 24.6 per 100,000 under 5 years of age. A relative increase in disease caused by meningococcal serogroup C was observed during the period of the study. Only 15% all cases could have been prevented by a policy of universal meningococcal group A and C immunisation at 2 years of age. Such a policy, therefore, is not recommended. A vaccine for preventing disease caused by meningococcal group B is urgently required.
Insights
Meningococcal disease in Dublin children (1981-1991) primarily affected those under 5. Vaccines for groups A and C were insufficient, highlighting the urgent need for a group B vaccine.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Epidemiology
Background:
- Meningococcal disease remains a significant public health concern in children.
- Understanding the epidemiology of meningococcal disease is crucial for effective prevention strategies.
- Previous vaccination efforts focused on specific serogroups, necessitating evaluation of their impact.
Purpose of the Study:
- To analyze the epidemiology of culture-confirmed meningococcal disease in children under 14 in Dublin from 1981-1991.
- To assess the potential effectiveness of existing meningococcal group A and C vaccines in preventing childhood disease.
- To identify the need for novel vaccine development against prevalent serogroups.
Main Methods:
- Retrospective analysis of microbiology laboratory records for pediatric meningococcal disease cases.
- Inclusion criteria: culture-confirmed cases in children under 14 years admitted to four Dublin hospitals (1981-1991).
- Epidemiological data analysis, including age distribution, seasonality, and serogroup prevalence.
Main Results:
- 406 cases identified; 78.6% in children under 5 years. Meningitis predominated over septicaemia (4:1 ratio).
- Peak incidence observed from November to March (53.2% of cases).
- Age-specific incidence rates were highest in infants under 1 year (64.2/100,000). A rise in serogroup C disease was noted.
Conclusions:
- Universal meningococcal group A and C immunization at 2 years would prevent only 15% of cases.
- Current vaccination strategies are insufficient for comprehensive prevention in this pediatric population.
- Development of a vaccine effective against meningococcal group B is urgently needed.