Invasive meningococcal disease in children in Ireland, 2001-2011.

Autor:	Ó Maoldomhnaigh C; Department of Pediatric Infectious Disease and Immunology, Our Lady's Children's Hospital, Crumlin, Ireland.; Department of Pediatric Infectious Disease, Temple Street Children's University Hospital, Dublin, Ireland., Drew RJ; Irish Meningococcal and Meningitis Research Laboratory, Children's University Hospital, Dublin, Ireland.; Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland.; Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland., Gavin P; Department of Pediatric Infectious Disease and Immunology, Our Lady's Children's Hospital, Crumlin, Ireland.; Department of Pediatric Infectious Disease, Temple Street Children's University Hospital, Dublin, Ireland., Cafferkey M; Irish Meningococcal and Meningitis Research Laboratory, Children's University Hospital, Dublin, Ireland.; Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland., Butler KM; Department of Pediatric Infectious Disease and Immunology, Our Lady's Children's Hospital, Crumlin, Ireland.; Department of Pediatric Infectious Disease, Temple Street Children's University Hospital, Dublin, Ireland.; UCD School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood [Arch Dis Child] 2016 Dec; Vol. 101 (12), pp. 1125-1129. Date of Electronic Publication: 2016 Aug 26.
DOI:	10.1136/archdischild-2015-310215
Abstrakt:	Background: In 1999, invasive meningococcal disease was hyperendemic in Ireland at 14.75/100 000 population, with 60% group B and 30% group C diseases. National sepsis guidelines and meningococcal C vaccines were introduced in 2000. Despite a spontaneous decline in group B infection, invasive meningococcal disease remains a leading cause of sepsis. This study characterises the epidemiology of invasive meningococcal disease in children in Ireland since the introduction of meningococcal C vaccine and reviews its clinical presentation, hospital course and outcome in anticipation of meningococcal B vaccine introduction. Methods: National surveillance data were obtained from the Health Protection Surveillance Centre. A retrospective study of all meningococcal cases at two tertiary paediatric hospitals was conducted from 2001 to 2011. Records were reviewed using a standardised assessment tool. A study of 407 meningococcal cases published in 2002 provided comparative data. Results: Of 1820 cases <19 years of age notified nationally, 382 (21%) cases attended a study hospital; 94% group B, 3% group C, 225 (59%) male, median age 5 years (range 0.1-18). Fever was absent at presentation in 18%. Fifteen patients (3.6%) died. 221 (61%) were admitted to paediatric intensive care units (PICU). Permanent sequelae occurred in 9.4%. Compared with the historical cohort, there were differences in presentation, an increase in PICU interventions, but no significant decline in morbidity or mortality. Conclusions: Despite the meningococcal C vaccination campaign, invasive meningococcal disease continues to cause serious morbidity and claim lives. Group B infections remain dominant. As children who die often present with fulminant disease, preventive strategies including use of meningococcal B vaccine are needed to avert death and sequelae. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
Databáze:	MEDLINE
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