BRITISH PAEDIATRIC SURVEILLANCE UNIT
Royal College of Paediatrics and Child Health
5-11 Theobalds Road, London WC1 X 8SH
Tel: 020 7092 6173 Fax: 020 7092 6196 Email: bpsu@rcpch.ac.uk Web: http://bpsu.inopsu.com
Bacterial meningitis in babies <90 days of age:
the current burden of disease
Abstract
Meningitis is associated with significant mortality and morbidity in infants in the first 3
months of life. The most recent national surveillance study (1996-7) identified an
overall mortality of 10% with 50% of cases having some form of disability at 5 year
follow-up (24% serious); a risk of serious disability 16-fold higher than that of
GP-matched controls. The mortality has declined over the last 2 decades but there
has been no change in the long term morbidity. There are a number of reasons why
the epidemiology and management of meningitis in this age group may have
changed over the last 10 years and an accurate picture of this is needed to allow
prioritisation and development of new strategies.
BPSU surveillance will be undertaken for 13 months.
Principal
Investigator
Dr. Paul T Heath
Child Health & Vaccine Institute
St George’s, University of London
Cranmer Terrace, London SW17 0RE
Research Fellow
Dr Ifeanyichukwu O Okike
St George’s Vaccine Institute
2nd Floor Ingleby House
SW17 0QT Tel: 020 87253887
email: meningitis@sgul.ac.uk
CoProf. Mary Cafferkey. Director Irish Meningococcal and Meningitis Reference
investigators Laboratory
Dr. Katy Sinka. Health Protection Scotland
Dr. Laura Jones. Consultant Paediatrician, Edinburgh
Dr. Nelly Ninis. Consultant Paediatrician, London
Dr. Alan Johnson. Health Protection Agency, London
Dr. Mark Anthony. Consultant Neonatologist, Oxford
Website
http://bpsu.inopsu.com/studies/current.html
Study website: www.neonin.org.uk
Background
Bacterial meningitis is associated with significant mortality and morbidity in newborn
infants. Knowledge of the current epidemiology and management of meningitis in this
age group is needed to allow prioritisation and development of new strategies.
Coverage
United Kingdom and Republic of Ireland
Duration
July 2010 to August 2011
BPSU Protocol card version 2 02 Jun 2010
Research
Questions
Primary Objective:
To define the minimum incidence of meningitis in the UK and Ireland in infants
aged less than 90 days
Secondary objectives:
1. To define the bacterial pathogens that causes meningitis in this age group
(and the antibiotic resistance profiles of these pathogens).
2. To describe the clinical presentation of cases of meningitis in this age group.
3. To describe the mortality and short-term complication rates of meningitis in
this age group.
4. To describe the current management of meningitis in this age group. For
instance, to define: initial place of diagnosis (home/hospital: ward, neonatal
unit, etc), timing of diagnosis relative to onset of initial symptoms of infection,
antibiotic(s) used at diagnosis of infection, time taken until appropriate
antibiotic(s) given (i.e. if initial antibiotic choice incorrect based on pathogen
type or antibiotic resistance profile), ultimate place of management (neonatal
unit, paediatric ward, PICU etc), and whether steroids used in management.
Case
definition
Any case where the clinician has made a clinical diagnosis of bacterial meningitis in
babies less than 90 days of age.
Reporting
instructions
Please report any baby seen in the last month who meets the case definition in the
UK or the Republic of Ireland from July 2010 regardless of country of birth.
Methods
Paediatricians reporting a case through the orange card system will be sent a
questionnaire which explores demographic and clinical information about the infant
and mother. A postage paid return envelope will be enclosed with the questionnaire.
Ethics
approval
This study has been approved by the Cambridgeshire 2 REC (Ref: 10/H0308/45)
and has been granted NIGB Section 251 Support Reference: PIAG/ BPSU 606(FT1)/2008.
Funding
Meningitis Research Foundation
References
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Holt DE, Halket S, de Louvois J, Harvey D. Neonatal meningitis in England and Wales:
10 years on. Arch Dis Child Fetal Neonatal Ed. 2001 Mar;84(2):F85-9.
Heath PT, Balfour G, Weisner AM, Efstratiou A, Lamagni TL, Tighe H, et al. Group B
streptococcal disease in UK and Irish infants younger than 90 days. Lancet. 2004 Jan
24;363(9405):292-4.
de Louvois J, Halket S, Harvey D. Neonatal meningitis in England and Wales: sequelae
at 5 years of age. Eur J Pediatr. 2005 Dec;164(12):730-4.
Heath PT, Nik Yusoff NK, Baker CJ. Neonatal meningitis. Arch Dis Child Fetal Neonatal
Ed. 2003 May;88(3):F173-8.
BPSU Protocol card version 2 02 Jun 2010