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Guidelines for the Early Clinical and Public Health Management of ...

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<strong>Guidelines</strong> <strong>for</strong> <strong>the</strong> <strong>Early</strong> <strong>Clinical</strong> <strong>and</strong> <strong>Public</strong> <strong>Health</strong> <strong>Management</strong> <strong>of</strong> Bacterial Meningitis (including Meningococcal Disease)<br />

Number <strong>of</strong> pneumococcal<br />

meningitis cases <strong>and</strong> deaths<br />

40<br />

35<br />

30<br />

25<br />

20<br />

15<br />

10<br />

5<br />

0<br />

1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010<br />

Cases 30 20 19 25 20 15 25 22 19 24 35 32 28 20<br />

Deaths 3 4 1 4 2 1 2 3 2 3 5 5 3 1<br />

Year<br />

Figure 5.10. Number <strong>of</strong> pneumococcal meningitis cases <strong>and</strong> deaths notified, 1997-2010<br />

The pneumococcal conjugate vaccine was introduced to <strong>the</strong> routine childhood immunisation schedule in 2008.<br />

Currently, <strong>the</strong>re is no designated reference laboratory in Irel<strong>and</strong> <strong>for</strong> <strong>the</strong> ongoing typing <strong>and</strong> genetic characterisation<br />

<strong>of</strong> S. pneumoniae strains. Such a service is essential in order to determine baseline distribution <strong>of</strong> strains prior to <strong>the</strong><br />

introduction <strong>of</strong> <strong>the</strong> vaccine, to assess <strong>the</strong> impact <strong>of</strong> <strong>the</strong> vaccine on IPD morbidity, mortality <strong>and</strong> serotype distribution,<br />

<strong>and</strong> to measure vaccine effectiveness. All <strong>the</strong>se facets <strong>of</strong> in<strong>for</strong>mation are vital on an ongoing basis to in<strong>for</strong>m public<br />

health vaccination policy <strong>and</strong> strategy regarding IPD in Irel<strong>and</strong>. A pilot pneumococcal typing project commenced in<br />

April 2007, a collaboration between <strong>the</strong> Department <strong>of</strong> <strong>Clinical</strong> Microbiology Research at RCSI/Beaumont Hospital,<br />

<strong>the</strong> Children’s University Hospital, Temple Street, <strong>and</strong> <strong>the</strong> <strong>Health</strong> Protection Surveillance Centre. Recent data from<br />

this project (comparing Jan-December 2008 with <strong>the</strong> same time period in 2011) has demonstrated a 91% decline in<br />

IPD incidence in children

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