title: Invasive meningococcal disease in children in Ireland, 2001-2011.
abstract: BACKGROUND
  In 1999, invasive meningococcal disease was hyperendemic in Ireland at 14.75/100 000 population, with 60% group B and 30% group C diseases. National sepsis guidelines and meningococcal C vaccines were introduced in 2000. Despite a spontaneous decline in group B infection, invasive meningococcal disease remains a leading cause of sepsis. This study characterises the epidemiology of invasive meningococcal disease in children in Ireland since the introduction of meningococcal C vaccine and reviews its clinical presentation, hospital course and outcome in anticipation of meningococcal B vaccine introduction.
  
  
  METHODS
  National surveillance data were obtained from the Health Protection Surveillance Centre. A retrospective study of all meningococcal cases at two tertiary paediatric hospitals was conducted from 2001 to 2011. Records were reviewed using a standardised assessment tool. A study of 407 meningococcal cases published in 2002 provided comparative data.
  
  
  RESULTS
  Of 1820 cases <19 years of age notified nationally, 382 (21%) cases attended a study hospital; 94% group B, 3% group C, 225 (59%) male, median age 5 years (range 0.1-18). Fever was absent at presentation in 18%. Fifteen patients (3.6%) died. 221 (61%) were admitted to paediatric intensive care units (PICU). Permanent sequelae occurred in 9.4%. Compared with the historical cohort, there were differences in presentation, an increase in PICU interventions, but no significant decline in morbidity or mortality.
  
  
  CONCLUSIONS
  Despite the meningococcal C vaccination campaign, invasive meningococcal disease continues to cause serious morbidity and claim lives. Group B infections remain dominant. As children who die often present with fulminant disease, preventive strategies including use of meningococcal B vaccine are needed to avert death and sequelae.
authors: Department of Pediatric Infectious Disease and Immunology, Our Lady's Children's Hospital, Crumlin, Ireland.|Department of Pediatric Infectious Disease, Temple Street Children's University Hospital, Dublin, Ireland.
authors: Cilian
authors: C
authors: Ó Maoldomhnaigh
authors: Irish Meningococcal and Meningitis Research Laboratory, Children's University Hospital, Dublin, Ireland.|Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland.|Department of Clinical Microbiology, Rotunda Hospital, Dublin, Ireland.
authors: Richard J
authors: RJ
authors: Drew
authors: Department of Pediatric Infectious Disease and Immunology, Our Lady's Children's Hospital, Crumlin, Ireland.|Department of Pediatric Infectious Disease, Temple Street Children's University Hospital, Dublin, Ireland.
authors: Patrick
authors: http://orcid.org/0000-0001-9845-1966
authors: P
authors: Gavin
authors: Irish Meningococcal and Meningitis Research Laboratory, Children's University Hospital, Dublin, Ireland.|Department of Clinical Microbiology, Royal College of Surgeons in Ireland, Dublin, Ireland.
authors: Mary
authors: M
authors: Cafferkey
authors: Department of Pediatric Infectious Disease and Immunology, Our Lady's Children's Hospital, Crumlin, Ireland.|Department of Pediatric Infectious Disease, Temple Street Children's University Hospital, Dublin, Ireland.|UCD School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
authors: Karina M
authors: KM
authors: Butler
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D022401:Meningococcal Vaccines; D012189:Retrospective Studies; D017678:Sex Distribution; D018074:Vaccines, Conjugate
chemical_list: D022401:Meningococcal Vaccines; D018074:Vaccines, Conjugate; C493331:meningococcal type B conjugate vaccine; C410218:serogroup C meningococcal conjugate vaccine
keywords: Epidemiology; Infectious Diseases; Invasive Meningococcal Disease