"Bacterial Meningitis in children and adolescents: an observational study based on the national surveillance system"

Abstract

Background: Bacterial meningitis is a group of life threatening infections that mostly affect children and adolescents, and may be the cause of severe neurological sequelae. Cuba has implemented massive vaccination programmes against both Neisseria meningitidis (serogroup C in 1979 and B in 1987), and Haemophilus influenzae type b (1999), two of the main causal pathogens. We described and discussed some epidemiological aspects of the current status of bacterial meningitis to learn from the Cuban experience.

Changing epidemiology of bacterial meningitis

“…In Uruguay, the total number of Hib cases fell from roughly 55 per 100,000 in 1994 to five per 100,000 in 1995 [17]. In Cuba, the conjugate vaccine was introduced in 1999, and the total overall incidence of Hib meningitis fell from three per 100,000 in 1999 to 0.1 per 100,000 in 2003 [18]. Accordingly, the greatest decrease in incidence of Hib meningitis occurred in children under 5 years of age; in 1998, there were 10.7 per 100,000 cases, and in 2003, no cases were detected [18].…”

“…In Cuba, the conjugate vaccine was introduced in 1999, and the total overall incidence of Hib meningitis fell from three per 100,000 in 1999 to 0.1 per 100,000 in 2003 [18]. Accordingly, the greatest decrease in incidence of Hib meningitis occurred in children under 5 years of age; in 1998, there were 10.7 per 100,000 cases, and in 2003, no cases were detected [18]. The Hib conjugate vaccine was introduced in the Kilifi District of Kenya in 2001.…”

Clonal Distribution of Disease-Associated and Healthy Carrier Isolates ofNeisseria meningitidisbetween 1983 and 2005 in Cuba

“…MD in Cuba has not been considered a public health prob-lem since the introduction of an outer membrane vesicle (OMV)-based vaccine (VA-MENGOC-BC) in the 1980s (16,41,46). The incidence of MD in the country slowly increased from a reported figure of 0.1 cases per 100,000 inhabitants in 1962 to 1.8 cases per 100,000 inhabitants in 1978, with most cases caused by serogroup C isolates.…”

Recent epidemiological changes in meningococcal disease may be due to the displacement of serogroup A by serogroup C in Hefei city, China

“…The seasonal pattern is affected by both environmental and social factors 27. An upsurge of meningococcal disease occurs in winter and spring—98.2% of cases occurred in this period.…”