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 Georges, University of London
Cranmer Terrace, London SW17 0RE

Research Fellow
Dr Ifeanyichukwu O Okike
St Georges Vaccine Institute
2nd Floor Ingleby House
SW17 0QT Tel: 020 8725 3887
email: meningitis@sgul.ac.uk

Prof. Mary Cafferkey. Director Irish Meningococcal and Meningitis Reference

Coinvestigators 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 July 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 6-06(FT1)/2008.

Funding

Meningitis Research Foundation

References

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