Meningitis and septicaemia disease trends
Meningitis and septicaemia trends
Meningitis Research Foundation collects data on the number of cases and incidence rates of
bacterial meningitis and septicaemia from the Health Protection Agency, Health Protection Scotland, Communicable Disease Surveillance Centre (NI), Health Protection Surveillance Centre (Republic of Ireland) and the Office of National Statistics.
There are several ways of recording the number of cases of meningitis and septicaemia:
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Laboratory confirmed
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Notifications
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Enhanced Surveillance
Laboratory confirmed
cases are collected from national reference labs or local microbiology labs that have analysed blood or cerebrospinal fluid (CSF) samples from patients with suspected meningitis or septicaemia. These data inform us of the type of meningitis or septicaemia (e.g. meningococcal, pneumococcal) and the serogroup (e.g. meningococcal group B or group C).
Notifications
are data obtained medical doctors who clinically diagnose meningococcal disease, or any form of meningitis, have a legal requirement to notify the local public health authorities. These notified figures can only provide information about the type of meningitis or septicaemia but not the serogroup.
Both laboratory confirmed and notifications data, however, underestimate true case numbers due to underreporting.
Enhanced surveillance
of Meningococcal Disease (ESMD) was set up to provide a more realistic estimate of the number of cases of meningococcal disease. ESMD attempts to reconcile reference laboratory data with notifications data, to get a more accurate picture of the number of cases each year. In reality, data collected through ESMD may overestimate cases, but together the 3 systems provide a more complete picture of disease levels and trends.
Surveillance of invasive pneumococcal disease (including pneumococcal meningitis, septicaemia and severe pneumonia) is enhanced and detailed figures of laboratory-confirmed cases are available. This scheme was set up to monitor the impact of the introduction of conjugate pneumococcal vaccine in 2006 in the UK.
Notified cases of meningococcal septicaemia and bacterial meningitis in England and Wales by year
- In England and Wales from 1999 to 2009 there was a 55% decrease in the total number of cases of meningococcal septicaemia and bacterial meningitis notified – mainly due to the drop in serogroup C meningococcal disease due to introduction of the MenC vaccine.
- Meningococcal infection has remained the leading cause of bacterial meningitis, followed by TB and pneumococcal
- Between 1999-2001 there was a steady increase in the number of Hib meningitis cases. However, Hib booster campaigns and the introduction of a routine booster vaccine in 2006 resulted in Hib disease being reduced in children under 5 years to its lowest level ever recorded in 2009.
Causes of bacterial meningitis in the UK and Republic of Ireland
Meningococcal septicaemia and bacterial meningitis in England and Wales by age
Meningococcal infection by type in England and Wales
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Meningococcal group B remains the main cause of meningococcal infection in England and Wales
- Between 1999 and 2010 there has been a steady decline in the total number of cases of meningococcal disease
- From 1998, cases of group C meningococcal infection have declined by 98%, due to the success of the MenC vaccination introduced in 1999/2000
- Cases of infection caused by group B continue to fluctuate unchecked. There has been a coincidental fall in cases of MenB from 2001-2010
- An outbreak of W135 meningococcal infection occurred amongst pilgrims on Hajj in 2000. Cases associated with those returning from Hajj were reported in many countries including the UK. The increase in case numbers of W135 from 1999-2001 can be attributed to this outbreak
Meningococcal cases in Scotland by type
Meningococcal cases in Northern Ireland by type
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Group B is the major cause of meningococcal infection in Northern Ireland. Levels of group B have remained relatively similar from 2005-2010
Meningococcal cases in the Republic of Ireland by type
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In Ireland over the period 1999-2007 the total number of meningococcal cases has decreased by two thirds (66%)
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This is largely due to the impact of MenC vaccination, introduced in 2000, which has reduced cases of group C disease by 98% (1999-2007)
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The levels of group W135 and Y have remained fairly consistent over this time
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A fall in group B cases has also occurred over this time period, due to natural fluctuation. There is no vaccine available to protect against MenB disease
- As with England and Wales a similar trend is shown for the Republic of Ireland; the number of meningococcal disease cases has continued to fall since 1999. This fall is largely due to the success of the MenC vaccine, introduced in 2000
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Overall, the number of meningococcal meningitis cases far exceeds all other causes of bacterial meningitis even though cases of meningococcal meningitis has substantially declined from 1999-2007
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Cases of TB meningitis have shown an increase from 2000-2007 due to a global elevation in TB during these years
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Pneumococcal infection represents the second main cause of bacterial meningitis in the Republic of Ireland
Pneumococcal cases in England and Wales by age
- Pneumococcal bacteria are responsible for several types of disease. These range in severity from invasive illnesses such as septicaemia, pneumonia and meningitis, to less severe infection such as earache.
- In 2007, in England and Wales alone there were 278 lab-confirmed cases of pneumococcal meningitis, much higher than the number of cases notified (173)
- Young children aged 0-4 years have the highest incidence of pneumococcal meningitis This demonstrates the value of having the pneumococcal vaccine early, at 2, 4, and 12-13 months of age, to protect those most at risk at a crucial time
- The second most vulnerable age group are people aged 65 and older