Meningococcal Diseases: Post Men C Vaccination Era
- Paediatric Registrar, Letterkenny University Hospital, Donegal
- Paediatric Registrar, University Hospital Waterford, Waterford
After the introduction of Men C vaccination in the year 2000, the incidence of meningococcal disease caused by Neisseria meningitidis Serotype C has significantly reduced, from a crude incidence rate of 4/ 100 000 population in the year 1999 to almost none in 2015. Interesting enough the incidence of those caused by Serotype B has also reduced which is most probably due to cross protection given by Men C vaccination from a crude incidence of 14.5/100 000 population in the year 1999 to approximately 4/100 000 population in 20151.
We did a retrospective study of thirty children whom lumbar puncture was performed with the preliminary diagnosis of meningococcal disease/ meningitis excluding neonates, those with non-infectious diagnosis and failed lumbar puncture. Investigations results that were taken into account for this study were Cerebrospinal fluid(CSF) culture, CSF Polymerase Chain Reaction (PCR) analysis for meningococcal , Blood PCR analysis for meningococcal, Peripheral blood culture (Blood C&S), C-Reactive Protein (CRP) of more than 10 and Total white cell count(WCC) of >15 or <4.
From our cohort twenty-one children (70%) received the Men C vaccination and nine (30%) did not. Five children (16.6%) were proven to have meningococcal disease. Three (60%) of them had a positive result for Meningococcal Serotype B, and these children received Men C vaccination. The other two children (40%) who did not receive any Men C vaccination had Serotype W135 in the culture/PCR. None of these children had N.Menigitidis Serotype C. This supports the efficiency of the vaccine.
Out of 1820 cases <19 years of age notified nationally, 382 (21%) cases attended a study hospital; the presence of Men C serotype was only 3%2.
The main aim is to ensure the uptake of Men C vaccination remains high to ensure the protective effect of it.
Dr Bazlin Ramly,
University Hospital Waterford.
1) Health Protection Surveillance Centre (2012). Guidelines for the early clinical and public health management of bacterial meningitis (including meningococcal disease) www.hpsc.ie/hpsc/AboutHPSC/ScientificCommittees/Publications/File,12977,en.pdf 2) Cilian Ó Maoldomhnaigh, Richard J Drew,Patrick Gavin, Mary Cafferkey, Karina M Butler, Invasive meningococcal disease in children in Ireland, 2001–2011. Arch Dis Child doi:10.1136/archdischild-2015-310215