Number of meningitis cases drops significantly

There has been a substantial drop in the number of cases of meningococcal disease, one of the main causes of meningitis, according…

There has been a substantial drop in the number of cases of meningococcal disease, one of the main causes of meningitis, according to latest figures from the Health Protection Surveillance Centre (HPSC).

Following the introduction of a vaccine (Men C) against the C strain of the meningococcus bug in 2000, the number of cases of meningitis and septicaemia due to meningococcus C has dropped from 139 cases in 2000 to just four cases in 2006. No young person has died in the Republic as a result of group C meningococcal disease in the last five years.

Figures from the first quarter of 2007 confirm this trend, with the number of invasive meningococcal disease (IMD) cases - which includes all strains of the meningococcus bacteria - dropping to 57 compared with a figure of 73 for the same period last year.

Commenting on the latest figures, Dr Margaret Fitzgerald, senior surveillance scientist with the HPSC, said: "The huge reduction of group C cases and deaths highlights the very positive impact of the introduction of Men C vaccination has had in reducing the burden of this serious, life-threatening disease in this country."

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The meningococcus bug causes two distinct illnesses: meningitis and septicaemia. When it invades the lining of the brain and spinal cord, it causes meningitis. A widespread infection of the blood results in septicaemia. Both illnesses can occur together, causing symptoms such as headache, neck stiffness, drowsiness and a characteristic skin rash.

There were two deaths from IMD in the first three months of this year, both of which occurred in the north-west of the country. The incidence of IMD was highest among infants under one year, at 23 cases per 100,000 infants, while four cases of IMD were reported in the 15-24 year age group giving an incidence of 1.3 per 100,000.

Other causes of bacterial meningitis include streptococcus pneumonia, haemophilus influenza and tuberculosis (TB).

Some 10 cases of streptococcus pneumonia meningitis occurred in the first quarter of this year, the same number as last year. Just one case of TB meningitis was reported. Haemophilus influenza also caused one case of meningitis in an adult compared to four cases in the first quarter of 2006, three of whom where children under one.

Meanwhile, the HPSC has also reported a significant drop in the number of children infected with haemophilus influenza type b (Hib). Towards the end of 2004, the agency became concerned when it noted a rise in Hib infections among children who had been fully vaccinated in the past. (A three-dose Hib vaccination for infants at two, four and six months was introduced to the routine immunisation schedule in 1992).

The National Immunisation Advisory Committee subsequently recommended a catch-up Hib dose be offered to children under four, starting in November 2005. As a result, just one Hib vaccine failure was reported in the 12 months from April 2006 to March 2007, compared with 12 such failures over the previous 12 months.

A routine Hib booster has now been included in the infant immunisation schedule at 12 months. "This substantial decline in vaccine failures is a very definite indication of the positive impact of the Hib immunisation catch-up booster campaign is having in protecting children from Hib disease," Dr Fitzgerald said.

The latest immunisation figures for children at 24 months shows an uptake of 91 per cent for completed Hib and Men C vaccination schedules. Uptake figures for the Hib booster dose are not yet available.

For more information on meningitis contact the Meningitis Research Foundation at 1890 413344 or www.meningitis.org