Bacterial Meningitis in the United States
Bacterial Meningitis in the United States
Source: Schuchat A, et al. Bacterial meningitis in the United States in 1995. N Engl J Med 1997;337:970-976.
Prior to the advent of hemophilus influenzae b (Hib) vaccine, Hib meningitis or invasive disease developed in up to one in 200 children by age 5. Multinational experience indicates dramatic declines in Hib disease, which hopefully portends actual elimination. The current report assesses the epidemiologic evolution of bacterial meningitis throughout the lifespan in the United States.
In 1994 and 1995, surveillance for five invasive bacterial diseases (Neisseria meningitides, H. influenzae, group B streptococcus, Listeria monocytogenes, and Streptococcus pneumoniae) was performed in 22 counties (in Georgia, Tennessee, Maryland, and California) representing more than 10 million personsapproximately 4% of the U.S. population. Results were compared with previously obtained surveillance data from 1986. Based upon these data, calculations reflecting projected epidemiology in the U.S. population as a whole are made and detailed below.
In 1995, an estimated 5755 cases of bacterial meningitis caused by the five reference pathogens occurred. When compared with the 12,920 cases occurring in 1986, this represents a 55% decrease. Attesting to the efficacy of Hib vaccination, the median age of bacterial meningitis patients increased from 15 months in 1986 to 25 years in 1995. Most of this epidemiologic shift has resulted from the 94% reduction in pediatric Hib meningitis.
The five study pathogens are responsible for at least 80% of all cases of bacterial meningitis. The very favorable effects of Hib immunization will hopefully be echoed by the development of equally effective vaccines for the other pathogens and increased use of existing vaccines (e.g., pneumococcal). v
Cases of meningitis in the United States during the last five years:
a. have decreased dramatically.
b. have a decreased median age.
c. have not been influenced by immunizations.
d. have been primarily caused by H. influenzae type B.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.