How many meningitis cases

The report suggests that the social distancing measures introduced in March to combat the spread of COVID have contributed to this fall in cases of disease.

We remain concerned that some people may be missing vaccine appointments due to concerns about travelling to a GP during the COVID pandemic. Parents of children who may have missed their scheduled immunisations due to self-isolation, or due to school closures, must ensure that this vaccine appointment is rescheduled as soon as possible.

No vaccine yet exists against GBS. But this method contributes to antibiotic overuse and resistance , and is expensive and logistically challenging—especially for the low-income countries that need intervention the most. PATH is working with Seattle-area biotechnology company Inventprise to develop a vaccine against GBS that can be delivered to pregnant women, who will then pass along protective antibodies to their babies—a strategy referred to as maternal immunization.

Though vaccines are only part of the defeating meningitis by strategy WHO is developing, they are an essential part, and one of the platforms upon which all other strategies hinge. Vaccines save countless lives by allowing us to prevent disease rather than just treat it. And with a disease as virulent as meningitis—prevention is key. Africa Gambia Meningitis Pneumonia Vaccines. PATH is on the front lines of an effort to defeat meningitis by We have the opportunity to protect millions more from meningitis by building new and better vaccines.

Stamping out epidemic meningitis. Affordable prevention. Vaccines save countless lives by allowing us to prevent disease rather than treat it. Protection for the very youngest. Additional resources. The available evidence indicates low incidence of sporadic meningococcal disease in India when compared to S. A recent review of published Indian studies has concluded that meningococcal disease in India is of low prevalence with occasional, but large, epidemics particularly in northern India [ 22 ].

In this report, meningococcal meningitis accounted for 2. An earlier study in six hospitals reported a low prevalence of meningococcal meningitis 1. Thus, it is clearly evident that meningococcal disease needs to be monitored on robust surveillance platforms with wider geographic representation to more effectively map the burden of meningococcal infection in India.

Annually about , to 1 million deaths attributable to pneumococcal disease occur globally with majority of them occurring in the developing countries. Hence, in WHO recommended the inclusion of pneumococcal conjugate vaccine, PCV7 in the national immunization programs [ 24 ]. The major pneumococcal serotypes identified in this study included 6B This finding is in agreement with the profile of pneumococcal serotypes recently published from India [ 8 ]. The successful management of bacterial meningitis depends on identification of the causative agent and appropriate antibiotic use [ 12 ].

There are reports of increasing drug resistance in S. Very high prevalence of penicillin resistant S. Similar to previous reports from the subcontinent, high resistance to cotrimoxazole and growing resistance to erythromycin is a point of concern as also evidenced in this study [ 2 , 28 , 29 , 31 , 32 ].

It would be advisable to generate pneumococcal serotyping data on more number of isolates to make more meaningful recommendations to the program. From the public health perspective, estimation of burden of bacterial meningitis by etiology is essential especially in settings where specific vaccines are yet to be introduced in the national immunization programmes.

The present study describes the burden of bacterial meningitis among under five children in India and highlights the predominance of S. The study emphasizes the need for continued monitoring to understand the emerging patterns of antibiotic resistance and distribution and variety of pneumococcal serotypes in India. National Center for Biotechnology Information , U. PLoS One. Published online May Vishnu Chaturvedi, Editor. Author information Article notes Copyright and License information Disclaimer.

Competing Interests: The authors have declared that no competing interests exist. Received Dec 22; Accepted Apr This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

This article has been cited by other articles in PMC. Abstract Background Worldwide, acute bacterial meningitis is a major cause of high morbidity and mortality among under five children, particularly in settings where vaccination for H. Methods During surveillance carried out in select hospitals across India in —, information regarding demographics, immunization history, clinical history, treatment details and laboratory investigations viz.

Results A total of suspected meningitis cases were enrolled from 19, children admitted with fever at the surveillance hospitals. Conclusions We observed that S. Introduction Globally, meningitis is a significant cause of morbidity and mortality in the pediatric population accounting for about , deaths annually [ 1 ].

Open in a separate window. Fig 1. Establishing the surveillance network The funding of each sentinel site was released after completion of procedural formalities such as approvals from the Institutional Ethics Committees and signing of Memorandum of Understanding between NIE and each of the participating institutions.

Ethics statement The present study was carried out in accordance with the Declaration of Helsinki. The clinical component Study population Children aged between 1 month and 59 months admitted to the selected sentinel site hospitals with complaints of fever and clinical suspicion of meningitis were eligible for enrollment. Patient enrolment Schematic overview of the case recruitment is presented in Fig 2.

Fig 2. Schematic overview of the case recruitment process in bacterial meningitis surveillance. Laboratory methods Under strict aseptic conditions 2—3 mL of venous blood and 2 mL of CSF by spinal tap from the lumbar region were collected. Training Hands-on induction and annual re-trainings covering clinical, laboratory and data aspects were conducted for all project personnel.

Quality assurance External quality assurance was conducted by the reference laboratory, which sent four proficiency panels each comprising four test strains to each sentinel site. Data management Data entry was performed using Epi-Info CDC at each participating site and data was transferred electronically to the coordinating center on a monthly basis. Fig 3. Summary of meningitis case recruitment and diagnostic testing performed during March —February Fig 4.

Fig 5. Table 2 Laboratory confirmation of bacterial meningitis pathogens. Many S. The relative contribution of each serotype to the local burden of disease varies globally, with serotypes 1 and 5 more prominent in developing countries.

Meningitis due to S. The case fatality rate for meningitis due to S. The risk of secondary cases of meningococcal disease among close contacts of someone with meningococcal disease i.

In non-epidemic settings, antimicrobial chemoprophylaxis is effective in preventing secondary cases among close contacts by eliminating nasopharyngeal carriage if administered rapidly after the index case is identified.

Such intervention may not be feasible in many countries. Secondary cases are also seen for Hib meningitis, particularly in unvaccinated children less than 4 years of age who are exposed to someone with Hib disease. Oral rifampin is recommended to eliminate nasopharyngeal carriage and prevent disease in these children.

Secondary meningitis cases are very rare among those exposed to a patient with pneumococcal disease. Laboratory surveillance data are critical to tracking the spread of less susceptible strains and to providing guidance in the empirical selection of antimicrobial agents. For all three bacterial meningitis pathogens, antimicrobial resistance has been identified, affecting the treatment of patients and chemoprophylaxis of close contacts.

Isolates resistant to rifampicin, penicillin, chloramphenicol, cotrimoxazole, ceftriaxone, and ciprofloxacin have also been identified One report from the United States described 2 isolates which were rifampin resistant Resistance to beta-lactam antimicrobials is common in H. The increasing proportion of pneumococci resistant to penicillin and the development of resistance to ceftriaxone has huge implications for treatment and makes prevention through vaccination that much more important.

The introduction of vaccine in the United States has resulted in a decreasing proportion of invasive isolates that are antibiotic-resistant, thus vaccine may have a role in controlling the spread of antibiotic resistance Vaccines are the cornerstone of prevention and control of bacterial meningitis.

Vaccines for N. Timely mass-vaccination campaigns using polysaccharide vaccines can effectively interrupt the course of meningitis epidemics, but they are less effective in young children, do not provide long duration of protection, do not have sustained impact on nasopharyngeal carriage, and therefore do not interrupt person to person transmission.

Conjugate vaccines generally result in higher levels of protection, longer duration of protection, protection of children less than 2 years of age, and may interrupt nasopharyngeal carriage and transmission, resulting in herd immunity.