Decline in pneumococcal meningitis after the introduction of the heptavalent-pneumococcal conjugate vaccine in northern France.

Abstract

The impact of the heptavalent-pneumococcal conjugate vaccine on the incidence of pneumococcal meningitis in Europe has not yet been assessed. To determine whether heptavalent-pneumococcal conjugate vaccine implementation in northern France has resulted in a decrease in the incidence of pneumococcal meningitis in children. Multicentre retrospective cohort study from 2000 through 2005. All paediatric departments of the 18 hospitals in northern France. Patients <18 years of age, admitted for laboratory-confirmed pneumococcal meningitis during the study period, were included. Data were collected from medical files and the microbiological laboratories of each hospital and compared with the regional hospital discharge codes, using a capture-recapture method. The study assessed and compared global and age-related incidence rates of pneumococcal meningitis in 2001 (pre-vaccine era) and 2005. 77 cases were found through the capture-recapture method. The incidence rate of pneumococcal meningitis varied from 1.65/100,000 children <18 years in 2001 to 0.80/100,000 children in 2005 (53% reduction, 95% CI 31 to 74; p = 0.08). This has so far been significant only for children <2 years of age (8.9/100,000 in 2001 to 1.8/100,000 in 2005; 82% reduction, 95% CI 52 to 95; p = 0.03). A decline in pneumococcal meningitis has been observed in infants since heptavalent-pneumococcal conjugate vaccination began in our area.