Meningococcal disease among children who live in a large metropolitan area, 1981-1996.
Neisseria meningitidis is an important cause of serious bacterial infections in children. We undertook a study to identify meningococcal infections of the blood, cerebrospinal fluid, or both of children in a defined geographic area to describe the burden of disease and the spectrum of illness. We reviewed the medical records of all children aged <18 years who had meningococcal infections at the 4 pediatric referral hospitals in Boston, Massachusetts, from 1981 through 1996. We identified 231 patients with meningococcal disease; of these 231 patients, 194 (84%) had overt disease and 37 (16%) had unsuspected disease. Clinical manifestations included meningitis in 150 patients, hypotension in 26, and purpura in 17. Sixteen patients (7%) died. Although meningococcal disease is devastating to a small number of children, we found that the burden of pediatric disease that it caused at the 4 pediatric referral centers in this geographic region was limited; that patients with overt meningococcal disease are most likely to have meningitis; and that individual practitioners are unlikely to encounter a patient with unsuspected meningococcal disease.
Emergency Medicine, Department of Medicine, Children's Hospital Boston, USA. wang@chla.usc.edu
V J
VJ
Wang
N
N
Kuppermann
R
R
Malley
E D
ED
Barnett
H C
HC
Meissner
E V
EV
Schmidt
G R
GR
Fleisher
D000293:Adolescent; D001900:Boston / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology*; D009345:Neisseria meningitidis; D011446:Prospective Studies