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Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease) Number of pneumococcal meningitis cases and deaths 40 35 30 25 20 15 10 5 0 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Cases 30 20 19 25 20 15 25 22 19 24 35 32 28 20 Deaths 3 4 1 4 2 1 2 3 2 3 5 5 3 1 Year Figure 5.10. Number of pneumococcal meningitis cases and deaths notified, 1997-2010 The pneumococcal conjugate vaccine was introduced to the routine childhood immunisation schedule in 2008. Currently, there is no designated reference laboratory in Ireland for the ongoing typing and genetic characterisation of S. pneumoniae strains. Such a service is essential in order to determine baseline distribution of strains prior to the introduction of the vaccine, to assess the impact of the vaccine on IPD morbidity, mortality and serotype distribution, and to measure vaccine effectiveness. All these facets of information are vital on an ongoing basis to inform public health vaccination policy and strategy regarding IPD in Ireland. A pilot pneumococcal typing project commenced in April 2007, a collaboration between the Department of Clinical Microbiology Research at RCSI/Beaumont Hospital, the Children’s University Hospital, Temple Street, and the Health Protection Surveillance Centre. Recent data from this project (comparing Jan-December 2008 with the same time period in 2011) has demonstrated a 91% decline in IPD incidence in children
Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease) Table 5.4. Reported neonatal meningitis cases by pathogen and year, 1999-2010 Pathogen 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 Total Streptococcus agalactiae (GBS) 0 0 1 1 1 3 3 2 4 2 2 3 22 Escherichia coli 0 1 0 0 1 0 0 2 0 7 0 1 12 Unknown 0 0 0 1 0 1 0 1 2 0 1 1 7 Neisseria meningitidis 1 0 0 1 1 0 0 1 0 1 1 1 7 Listeria species 0 0 2 0 1 0 0 0 0 1 0 0 4 Streptococcus pneumoniae 0 0 0 0 1 0 0 0 0 2 0 0 3 Salmonella 0 0 0 0 1 0 0 0 0 0 0 0 1 Streptocococcus species 0 0 0 0 0 0 0 0 0 0 0 1 1 Staphylococcus aureus 0 0 0 0 0 0 0 0 0 0 0 1 1 All neonatal cases 1 1 3 3 6 4 3 6 6 13 4 8 58 5.9. Tuberculosis meningitis Tuberculosis meningitis will not be discussed in this report. Guidelines on the Prevention and Control of Tuberculosis in Ireland have been prepared by the National Tuberculosis Advisory Committee, details of which are available at: http://www.hpsc.ie/hpsc/A-Z/VaccinePreventable/TuberculosisTB/Guidance/. -51-
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