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    Rights statement: © 2011 Stanton et al. 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.

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Meningococcal disease in children in Merseyside, England: a 31 year descriptive study

Research output: Contribution to journalJournal articlepeer-review

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  • Michelle C. Stanton
  • David Taylor-Robinson
  • David Harris
  • Fauzia Paize
  • Nick Makwana
  • Scott J. Hackett
  • Paul B. Baines
  • F. Andrew I. Riordan
  • Omnia Marzouk
  • Alistair P. J. Thomson
  • Peter J. Diggle
  • C. Anthony Hart
  • Enitan D. Carrol
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Article numbere25957
<mark>Journal publication date</mark>7/10/2011
<mark>Journal</mark>PLoS ONE
Issue number10
Volume6
Number of pages7
Pages (from-to)-
Publication StatusPublished
<mark>Original language</mark>English

Abstract

Meningococcal disease (MCD) is the leading infectious cause of death in early childhood in the United Kingdom, making it a public health priority. MCD most commonly presents as meningococcal meningitis (MM), septicaemia (MS), or as a combination of the two syndromes (MM/MS). We describe the changing epidemiology and clinical presentation of MCD, and explore associations with socioeconomic status and other risk factors. A hospital-based study of children admitted to a tertiary children's centre, Alder Hey Children's Foundation Trust, with MCD, was undertaken between 1977 to 2007 (n = 1157). Demographics, clinical presentations, microbiological confirmation and measures of deprivation were described. The majority of cases occurred in the 1-4 year age group and there was a dramatic fall in serogroup C cases observed with the introduction of the meningococcal C conjugate (MCC) vaccine. The proportion of MS cases increased over the study period, from 11% in the first quarter to 35% in the final quarter. Presentation with MS (compared to MM) and serogroup C disease (compared to serogroup B) were demonstrated to be independent risk factors for mortality, with odds ratios of 3.5 (95% CI 1.18 to 10.08) and 2.18 (95% CI 1.26 to 3.80) respectively. Cases admitted to Alder Hey were from a relatively more deprived population (mean Townsend score 1.25, 95% CI 1.09 to 1.41) than the Merseyside reference population. Our findings represent one of the largest single-centre studies of MCD. The presentation of MS is confirmed to be a risk factor of mortality from MCD. Our study supports the association between social deprivation and MCD.

Bibliographic note

© 2011 Stanton et al. 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.