Incidence of viral meningitis grossly under-reported

NEHB study: The incidence of viral meningitis in the North Eastern Health Board (NEHB) region has been grossly under-reported…

NEHB study: The incidence of viral meningitis in the North Eastern Health Board (NEHB) region has been grossly under-reported in recent years, a new study has found.

Researchers have looked at the number of people from the region hospitalised with viral meningitis over the five-year period from 1997 to 2001 and compared it with the number of cases of viral meningitis reported by the region to the National Disease Surveillance Centre (NDSC) over the same period.

They found 265 people from the region were admitted to hospital with viral meningitis over the five years but the number of notifications of the disease to the NDSC over the same period was just 38.

The researchers, who work in the health board's department of public health, said infectious disease regulations of 1981 specify that as soon as a medical practitioner becomes aware of or suspects a patient is suffering from or is a carrier of particular infectious diseases, he or she is required to transmit a written notification to the relevant medical officer in his or her health board area.

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But they said their study established this wasn't happening. "The study demonstrates that the number of NEHB residents hospitalised for viral meningitis increased significantly between 1997 and 2001 and that the majority of these cases were not notified."

Their study, published in the latest edition of the Irish Medical Journal, said hospitalisations with the infection increased from 21 in 1997 to 111 in 2001, an increase of 429 per cent.

"Clearly the recent increases in viral meningitis cases and the associated morbidity and mortality are a cause for concern," they said. "The under-reporting of viral meningitis hospitalised cases in NEHB residents is alarming. If this level of under-reporting is similar in other health boards, then the national figures for viral meningitis are also grossly underestimated.

"The disease burden of viral meningitis and perhaps other diseases goes essentially unnoticed and this has implications for both notifiable infectious disease policy and surveillance in Ireland. This under-reporting casts doubt on the effectiveness of the notification process as a 'real time' surveillance tool and an early warning system for outbreaks," they added.

The authors of the report include Dr Elaine Brabazon, Dr Peter Finnegan, Dr Ciara Murray and Ms Ann O'Farrell. Dr Finnegan said it appeared doctors just weren't aware of the importance of notifying the authorities about viral meningitis - viral meningitis is one of two main types of meningitis, the other being bacterial. The viral form is the most common and is a milder disease compared to the bacterial form and is rarely fatal.