Evolución de la enfermedad meningocócica en la población infantil de la Comunidad Valenciana (1996-2000): Efectividad de la vacunación antimeningocócica A+C

Abstract

Evolution of Meningococcal Disease among the Infantile Population in the Autonomous Community of Valencia (1996-200). Effectivity of A+C Meningococcal Vaccination Bacground: The increase in meningococcal disease caused by serogroup C in the Autonomous Community of Valencia during the 1996-1997 period gave rise to an A+C meningococcal vaccination campaign having been conducted targeting the population ranging from 18 months to 19 years of age. The purpose of this study is that of analyzing the impact of this campaign regarding the epidemiology, clinical aspects and evolution of meningococcal disease and the vaccination status of the youth population for the purpose of evaluating the efficacy of this vaccination. Methods: The data was taken from the clinical records of the children under 15 years of age who showed clinical signs and symptoms suggesting an invasive disease with isolation of Neisseria meningitidis and/or which meet the established case definition criteria which had been treated at all of the public hospital in the Autonomous Community of Valencia within the 1996-2000 period. The trend of incidence was evaluated by means of incidence rates. The clinical aspects and their progress (sequelae and lethality) by frequency and distribution by serogroup and age. The vaccination efficacy was calculated using the Orestein equation. Results: A total of 302 cases of invasive disease caused by N. Meningitidis were recorded. The rate of incidence by serogroup C in children under age 15 dropped following the vaccination campaign from 5.82/10 5 habitants in 1997 to 1.68/10 5 habitants in 1998. Rates similar to those prior to the time prior to the vaccination recorded three years subsequent to the campaign, showing an increase in the disease caused by serogroup B over the last 2 years. Sixty-one percent of the sequelae were among children under 5 years of age. Lethality was higher for serogroup C. Vaccination efficacy three years subsequent to the campaign was 83.7% for the 5-14 age range and 69.1% for the 19month-4 year age range. Conclusion: The polysaccharide vaccine was shown to be effective for halting the outbreak. The drop in the incidence of serogroup C can be attributed to the vaccination efficacy achieved.

Meningitis Agudas en Córdoba,Colombia 2002 - 2004

“…Con respecto a N. meningitidis serotipo B, 3 de los 4 pacientes confirmados con cultivo resultaron positivos por la prueba de detección de antígenos (75 %). En contraste, en Valencia (España), en 96 % de los casos se aisló el germen y sólo en 3 % se realizó el diagnóstico por detección de antígenos (24). En nuestros 2 pacientes con cultivos positivos para S. agalactiae fueron positivos a la prueba de antígenos en LCR (100 %); para Hib sólo uno de los 2 casos presentó prueba de látex positiva (50 %).…”

“…La tasa de letalidad general fue de 38,6 %, de los cuales 11 eran pacientes pediátricos (letalidad de 31,4 %) y 11 pacientes adultos (letalidad del 50 %). Esta alta letalidad no está de acuerdo con los resultados de otros trabajos en España (5,3 %) y Guatemala (23 %) (21,24), lo que demuestra que existe un problema de vigilancia sobre la meningitis en Córdoba.…”