Clinically based surveillance of invasive meningococcal disease in young children admitted to selected US hospitals between January 2000 and June 2009: a retrospective cohort study

Human Vaccines & Immunotherapeutics
Ariel BergerGerry Oster

Abstract

Invasive meningococcal disease (IMD) is under-reported in countries that do not employ polymerase-chain reaction for surveillance because culture-negative cases are omitted. To evaluate a clinically based, case-finding method, we developed case definitions for "probable," "compatible with," and "possible, but unlikely" IMD, respectively, based on supportive documentation (e.g., discharge diagnosis of meningococcal infection, culture-negative bacterial meningitis, petechiae/purpura, Gram-negative diplococci on Gram stain) and weight of clinical evidence, which we then applied to electronic health records for all children aged ≤5 y who were admitted to approximately 100 US hospitals between January 2000 and June 2009. Among 47,863 qualifying admissions, 16 children had culture-positive IMD, 5 had "probable" IMD, and 5 had illness "compatible with" IMD. Five additional children had disease considered "possible but unlikely" IMD. Our case-finding methods suggest that culture-based ascertainment may underestimate the number of IMD cases by 31-63%, supporting findings in other nations that culture-based reporting provides incomplete information on disease incidence and therefore underestimates the potential benefits of routine vaccin...Continue Reading

References

May 3, 2001·The New England Journal of Medicine·N E RosensteinJ M Hughes
Feb 7, 2006·Lancet·Matthew J ThompsonMichael Levin
Jun 15, 2006·Journal of Medical Microbiology·UNKNOWN Meningococcal Reference UnitEdward B Kaczmarski
May 1, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kate C CummingsJon Rosenberg
Nov 26, 2008·Diagnostic Microbiology and Infectious Disease·Carmen Munoz-AlmagroIolanda Jordan
Dec 17, 2009·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Amanda C CohnNancy E Messonnier
Apr 23, 2010·The New England Journal of Medicine·Lionel K K TanRay Borrow

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