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Bacterial meningitis in the United States in 1995. Active Surveillance Team

A Schuchat1, K Robinson, J D Wenger

  • 1Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.

The New England Journal of Medicine
|February 12, 1998
PubMed
Abstract

Insights

Haemophilus influenzae type b conjugate vaccines significantly reduced bacterial meningitis cases, shifting the disease

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Vaccinology

Background:

  • Haemophilus influenzae type b (Hib) was a leading cause of bacterial meningitis in US infants and young children before conjugate vaccine introduction.
  • Meningitis was historically a pediatric disease, primarily affecting infants and young children.

Purpose of the Study:

  • To describe the epidemiologic features of bacterial meningitis five years after the licensure of Hib conjugate vaccines for routine infant immunization.
  • To assess the impact of Hib conjugate vaccines on the incidence and demographics of bacterial meningitis.

Main Methods:

  • Active, population-based surveillance for culture-confirmed meningitis and invasive bacterial disease was conducted in 22 counties across four states in 1995.
  • Surveillance data covered a population of over 10 million, with rates compared to similar surveillance data from 1986.
  • Data collection involved laboratories from all acute care hospitals within the designated surveillance areas.

Main Results:

  • In 1995, the incidence rates per 100,000 for major bacterial meningitis pathogens were: Streptococcus pneumoniae (1.1), Neisseria meningitidis (0.6), group B streptococcus (0.3), Listeria monocytogenes (0.2), and H. influenzae (0.2).
  • Group B streptococcus predominated in newborns, N. meningitidis in children aged 2-18, and S. pneumoniae in adults.
  • An estimated 5755 cases of bacterial meningitis occurred in the US in 1995, a 55% reduction from 12,920 cases in 1986, largely due to a 94% decrease in Hib meningitis cases. The median age of affected individuals increased from 15 months in 1986 to 25 years in 1995.

Conclusions:

  • The widespread use of Hib conjugate vaccines has dramatically reduced bacterial meningitis incidence in the United States.
  • Bacterial meningitis is now predominantly a disease affecting adults, rather than infants and young children, due to the decline in Hib cases.

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