title: The Burden of Pediatric Invasive Meningococcal Disease in Spain (2008-2013).
abstract: BACKGROUND
  Invasive meningococcal disease remains a rare infectious disease not only with high mortality but also with important morbidity. Until recently no universal vaccine existed against serogroup B, which explains most of the cases in settings like Europe. The objective of this study was to analyze the clinical course and sequelae of meningococcal disease in Spain.
  
  
  METHODS
  Retrospective review of all children younger than 15 years admitted to any of the 36 hospitals in the MENDICOS Spanish network (www.mendicos.org) with confirmed or probable invasive meningococcal disease in children between January 2008 and December 2013.
  
  
  RESULTS
  A total of 458 cases were identified across the country, most of them occurring in previously healthy children (91.5%; n = 419/458). Median (interquartile range) age was 1.7 (0.7 and 4.6) years, with 53.1% of the cases occurring in children younger than 2 years; 82.1% (n = 368) were laboratory confirmed cases; 95.2% (n = 256) of those serogrouped were serogroup B. The diagnosis was meningitis in 24.9% (n = 114) of the cases, sepsis in 37.1% (n = 170) and both in 38.0% (n = 174). Mean hospital length of stay was 11.6 (10.9) days; 79.2% (n = 354) of the patients required pediatric intensive care unit admission, with a mean pediatric intensive care unit stay of 3.9 (4.9) days; 3.5% (n = 16) died; 12.9% (n = 59) of the survivors were discharged with some kind of physical sequelae, mainly neurological (n = 23).
  
  
  CONCLUSIONS
  Serogroup B invasive meningococcal infection explains substantial morbidity and mortality in Spain, occurring mainly in infants. The recent availability of a vaccine against serogroup B may change this scenario. Given that the vast majority of the cases occur in otherwise healthy children, inclusion of the meningococcal B vaccine in the national immunization program should be carefully considered.
authors.affiliation: From the *Translational Pediatrics and Infectious Diseases Section, Pediatrics Department, Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; †Genetics Vaccines Infections and Pediatrics Research Group (GENVIP), Healthcare Research Institute of Santiago de Compostela, Santiago de Compostela, Spain; and ‡Members of MENDICOS Research Network are listed in Appendix.
authors.forename: Irene
authors.initials: I
authors.lastname: Rivero-Calle
authors.forename: Lucia
authors.initials: L
authors.lastname: Vilanova-Trillo
authors.forename: Jacobo
authors.initials: J
authors.lastname: Pardo-Seco
authors.forename: Lidia Blanco
authors.initials: LB
authors.lastname: Salvado
authors.forename: Laura Illade
authors.initials: LI
authors.lastname: Quinteiro
authors.forename: Federico
authors.initials: F
authors.lastname: Martinon-Torres
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D049674:History, 21st Century; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000266:history / Q000628:therapy; D009345:Neisseria meningitidis; D063868:Patient Outcome Assessment; D011159:Population Surveillance; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology