Meningococcal disease in children in Merseyside, england: A 31 year descriptive study

Michelle C. Stanton, David Taylor-Robinson, David Harris, Fauzia Paize, Nick Makwana, Scott J. Hackett, Paul B. Baines, F. Andrew I Riordan, Omnia Marzouk, Alistair P J Thomson, Peter J. Diggle, C. Anthony Hart, Enitan D. Carrol

Research output: Contribution to journalArticle

Abstract

Meningococcal disease (MCD) is the leading infectious cause of death in early childhood in the United Kingdom, making it a public health priority. MCD most commonly presents as meningococcal meningitis (MM), septicaemia (MS), or as a combination of the two syndromes (MM/MS). We describe the changing epidemiology and clinical presentation of MCD, and explore associations with socioeconomic status and other risk factors. A hospital-based study of children admitted to a tertiary children's centre, Alder Hey Children's Foundation Trust, with MCD, was undertaken between 1977 to 2007 (n = 1157). Demographics, clinical presentations, microbiological confirmation and measures of deprivation were described. The majority of cases occurred in the 1-4 year age group and there was a dramatic fall in serogroup C cases observed with the introduction of the meningococcal C conjugate (MCC) vaccine. The proportion of MS cases increased over the study period, from 11% in the first quarter to 35% in the final quarter. Presentation with MS (compared to MM) and serogroup C disease (compared to serogroup B) were demonstrated to be independent risk factors for mortality, with odds ratios of 3.5 (95% CI 1.18 to 10.08) and 2.18 (95% CI 1.26 to 3.80) respectively. Cases admitted to Alder Hey were from a relatively more deprived population (mean Townsend score 1.25, 95% CI 1.09 to 1.41) than the Merseyside reference population. Our findings represent one of the largest single-centre studies of MCD. The presentation of MS is confirmed to be a risk factor of mortality from MCD. Our study supports the association between social deprivation and MCD.

Original languageEnglish (US)
Article numbere25957
JournalPLoS One
Volume6
Issue number10
DOIs
StatePublished - Oct 7 2011
Externally publishedYes

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

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    Stanton, M. C., Taylor-Robinson, D., Harris, D., Paize, F., Makwana, N., Hackett, S. J., Baines, P. B., Riordan, F. A. I., Marzouk, O., Thomson, A. P. J., Diggle, P. J., Hart, C. A., & Carrol, E. D. (2011). Meningococcal disease in children in Merseyside, england: A 31 year descriptive study. PLoS One, 6(10), [e25957]. https://doi.org/10.1371/journal.pone.0025957