Advertisement
Research Article| Volume 80, ISSUE 3, P286-290, March 2020

Invasive meningococcal disease: Timing and cause of death in England, 2008–2015

Published:January 02, 2020DOI:https://doi.org/10.1016/j.jinf.2019.12.008
Invasive meningococcal disease: Timing and cause of death in England, 2008–2015
Previous ArticleVentilator-associated pneumonia due to Stenotrophomonas maltophilia: Risk factors and outcome
Next ArticleEtiology, clinical presentation, outcome and the effect of initial management in immunocompromised patients with community acquired bacterial meningitis

      Summary

      Background

      Neisseria meningitidis is a major cause of bacterial meningitis and septicaemia, with death often occurring rapidly after onset of the first symptoms. Later death can also occur, but may be due to other causes, such as underlying comorbidities. The study aimed to assess the timing and cause of death in patients with invasive meningococcal disease (IMD) prior to the introduction of two new meningococcal immunisation programmes in England.

      Methods

      Public Health England (PHE) conducts IMD surveillance in England through its national meningococcal reference unit. Laboratory-confirmed IMD cases diagnosed during 2008–2015 were linked to weekly and annual electronic death registration records as well as the Patient Demographic Service (PDS) database.

      Results

      Overall, 6734 of 6808 (99%) laboratory-confirmed IMD cases matched to PDS, including 668 fatalities. Of these, 667 linked to an annual death registration record compared to 405 reports linked to weekly death registrations. In total, 429/667 (64%) of all deaths and 428/502 (85%) of IMD-related deaths occurred within one day of diagnosis. In total, 498/667 (75%) deaths had occured by 30 days after IMD diagnosis and 98% (490/498) of these were IMD-related. Serogroup B contributed to 64% (323/502) of IMD-related deaths, followed by serogroup W (84/502, 17%) and serogroup Y (70/502, 14%). Deaths occurring after 30 days were less likely to be IMD-related, mainly amongst ≥65 year-olds, with malignancy, chronic respiratory and cardiac conditions predominating.

      Conclusions

      Most IMD-related deaths occurred within a day of diagnosis and nearly all IMD-related deaths occurred within 30 days of diagnosis. The rapidity of death highlights the importance of prevention through vaccination.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Infection
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Register: Create an account
      Institutional Access: Sign in to ScienceDirect

      References

        • Halperin S.A.
        • Bettinger J.A.
        • Greenwood B.
        • Harrison L.H.
        • Jelfs J.
        • Ladhani S.N.
        • et al.
        The changing and dynamic epidemiology of meningococcal disease.
        Vaccine. 2012; 30 (Suppl): B26-B36
        View in Article
        • Thompson M.J.
        • Ninis N.
        • Perera R.
        • Mayon-White R.
        • Phillips C.
        • Bailey L.
        • et al.
        Clinical recognition of meningococcal disease in children and adolescents.
        Lancet. 2006; 367: 397-403
        View in Article
        • Campbell H.
        • Andrews N.
        • Borrow R.
        • Trotter C.
        • Miller E.
        Updated postlicensure surveillance of the meningococcal C conjugate vaccine in England and Wales: effectiveness, validation of serological correlates of protection, and modeling predictions of the duration of herd immunity.
        Clin Vaccine Immunol. 2010; 17: 840-847
        View in Article
        • Ladhani S.N.
        • Beebeejaun K.
        • Lucidarme J.
        • Campbell H.
        • Gray S.
        • Kaczmarski E.
        • et al.
        Increase in endemic Neisseria meningitidis capsular group W sequence type 11 complex associated with severe invasive disease in England and Wales.
        Clin Infect Dis: Off Publ Infect Dis Soc Am. 2015; 60: 578-585
        View in Article
        • Campbell H.
        • Edelstein M.
        • Andrews N.
        • Borrow R.
        • Ramsay M.
        • Ladhani S.
        Emergency meningococcal acwy vaccination program for teenagers to control group w meningococcal disease, england, 2015-2016.
        Emerg Infect Dis. 2017; 23: 1184-1187
        View in Article
        • Ladhani S.N.
        • Ramsay M.
        • Borrow R.
        • Riordan A.
        • Watson J.M.
        • Pollard A.J.
        Enter b and W: two new meningococcal vaccine programmes launched.
        Arch Dis Child. 2016; 101: 91-95
        View in Article
        • Parikh S.R.
        • Campbell H.
        • Gray S.J.
        • Beebeejaun K.
        • Ribeiro S.
        • Borrow R.
        • et al.
        Epidemiology, clinical presentation, risk factors, intensive care admission and outcomes of invasive meningococcal disease in England, 2010-2015.
        Vaccine. 2018; 36: 3876-3881
        View in Article
        • Campbell H.
        • Borrow R.
        • Arumugam C.
        • Ramsay M.
        • Ladhani S.N.
        Invasive meningococcal disease as a cause of sudden and unexpected death in a teenager: the public health importance of confirming the diagnosis.
        J Infect. 2019; 78: 323-337
        View in Article
        • Ladhani S.
        • Pebody R.G.
        • Ramsay M.E.
        • Lamagni T.L.
        • Johnson A.P.
        • Sharland M.
        Continuing impact of infectious diseases on childhood deaths in England and Wales, 2003-2005.
        Pediatr Infect Dis J. 2010; 29: 310-313
        View in Article
        • Viner R.M.
        • Booy R.
        • Johnson H.
        • Edmunds W.J.
        • Hudson L.
        • Bedford H.
        • et al.
        Outcomes of invasive meningococcal serogroup b disease in children and adolescents (MOSAIC): a case-control study.
        Lancet Neurol. 2012; 11: 774-783
        View in Article

      Article info

      Publication history

      Published online: January 02, 2020
      Accepted: December 17, 2019

      Identification

      DOI: https://doi.org/10.1016/j.jinf.2019.12.008

      Copyright

      © 2019 Published by Elsevier Ltd on behalf of The British Infection Association.

      ScienceDirect

      Access this article on ScienceDirect

      The content on this site is intended for healthcare professionals.


      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the Cookie Preference Center for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties.


      RELX