Meningococcal deaths plummet

Children are now vaccinated against meningitis C

There has been a dramatic fall in deaths from meningococcal disease, studies from two specialist units have shown.

Alder Hey Children's Hospital in Liverpool and St Mary's Hospital in London both looked at death rates from the disease, and saw significant drops.

In the south of England, St Mary's say death rates fell by almost 60% between 1992 and 1997.

The Liverpool study found the death rate at their specialist centre was 16% lower than the predicted level.

The vaccine was introduced two years ago

The studies are published in the journal Archives of Disease in Childhood, which also features a study showing that the meningococcal C vaccine is safe, and has minimal side-effects.

The vaccine was introduced in November 1999, and at least 15m children and teenagers are estimated to have received it so far.

Meningococcal disease includes meningitis and septicaemia, a potentially deadly infection of the bloodstream.

It is caused by the infectious agent, Neisseria meningitidis.

One in 10 patients with meningitis, and as many of those with meningococcal shock will die, despite treatment with antibiotics.

The condition can also leave people permanently disabled from limb amputations, extensive scarring, or neurological injury.

Specialist unit

Researchers from St Mary's Hospital, London, looked at how the introduction of a paediatric intensive care unit (PICU), which specialised in meningococcal disease, in 1992 affected how children with the disease fared.

The hospital also produced educational material for non-specialist hospitals, and a mobile intensive care team to transfer children from local hospitals to St Mary's.

The study looked at 331 children, aged between two and 17.

Three quarters of the cases were septicaemia, or blood poisoning.

Among the 33 deaths over five years, 29 were in children with septicaemia, or blood poisoning.

In 1992-3 the death rate in patients was 23%.

A comprehensive vaccination programme, coupled with rapid response to and effective treatment of meningitis & meningococcal disease is vita

Sarah Booker
Meningitis Trust

But although the numbers of admissions increased, only two children died in that year, well below the expected rate of 38.

The risk of fatality over that period fell by 59%.

Amongst survivors, the rate of complication stayed roughly the same, though the rate of neurological complications fell slightly.

The researchers say increased expertise both at St Mary's and at local hospitals means earlier and more effective treatment, helping to cut the death rate.

Doctors at Alder Hey Children's Hospital monitored 123 children with meningococcal disease who were admitted to the hospital's PICU between 1995 and 1998.

They were aged between two months and 16 years.

Eleven of the children died, a death rate of just under 9%.

An assessment of the likelihood of death based on the severity of the disease showed the rates should have been almost 25%.

Writing in the Archives of Disease in Childhood, the authors, led by Dr Paul Baines, said the reason for the fall in death rates was not obvious, but increased awareness was likely to have helped.

The research which looked at the men C vaccine offers more confirmation that this vaccine has been shown to be extremely safe

Julia Warren
Meningitis Research Foundation

The meningitis C vaccine, which is estimated to have reduced incidence of the disease by 80%, is safe, researchers from the Institute of Child Health at the University of Bristol confirm.

They looked at almost 3,000 children, from around Sheffield, and Scotland, who were given the vaccine between two and five months of age.

Two thirds of children reported adverse events during the study but most were mild and were not thought to be related to the vaccine.

Five children did suffer soreness and swelling around the site of the injection.

Sarah Booker, of the Meningitis Trust, said the three studies demonstrate "a comprehensive vaccination programme, coupled with rapid response to and effective treatment of meningitis & meningococcal disease is vital".

Julia Warren, of the Meningitis Research Foundation, said the studies from Alder Hey and St Mary's confirmed the importance of increased awareness of meningococcal disease.

She added: "The research which looked at the men C vaccine offers more confirmation that this vaccine has been shown to be extremely safe."