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Invasive meningococcal disease: Timing and cause of death in England, 2008–2015

Beebeejaun, K; Parikh, SR; Campbell, H; Gray, S; Borrow, R; Ramsay, ME; Ladhani, SN (2020) Invasive meningococcal disease: Timing and cause of death in England, 2008–2015. Journal of Infection, 80 (3). pp. 286-290. ISSN 0163-4453 https://doi.org/10.1016/j.jinf.2019.12.008
SGUL Authors: Ladhani, Shamez Nizarali

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Abstract

Background Neisseria meningitidis is a major cause of bacterial meningitis and septicaemia, with death often occurring rapidly after onset of the first symptoms. Later death can also occur, but may be due to other causes, such as underlying comorbidities. The study aimed to assess the timing and cause of death in patients with invasive meningococcal disease (IMD) prior to the introduction of two new meningococcal immunisation programmes in England. Methods Public Health England (PHE) conducts IMD surveillance in England through its national meningococcal reference unit. Laboratory-confirmed IMD cases diagnosed during 2008–2015 were linked to weekly and annual electronic death registration records as well as the Patient Demographic Service (PDS) database. Results Overall, 6734 of 6808 (99%) laboratory-confirmed IMD cases matched to PDS, including 668 fatalities. Of these, 667 linked to an annual death registration record compared to 405 reports linked to weekly death registrations. In total, 429/667 (64%) of all deaths and 428/502 (85%) of IMD-related deaths occurred within one day of diagnosis. In total, 498/667 (75%) deaths had occured by 30 days after IMD diagnosis and 98% (490/498) of these were IMD-related. Serogroup B contributed to 64% (323/502) of IMD-related deaths, followed by serogroup W (84/502, 17%) and serogroup Y (70/502, 14%). Deaths occurring after 30 days were less likely to be IMD-related, mainly amongst ≥65 year-olds, with malignancy, chronic respiratory and cardiac conditions predominating. Conclusions Most IMD-related deaths occurred within a day of diagnosis and nearly all IMD-related deaths occurred within 30 days of diagnosis. The rapidity of death highlights the importance of prevention through vaccination.

Item Type: Article
Additional Information: © 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Microbiology, 1103 Clinical Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Journal of Infection
ISSN: 0163-4453
Language: en
Dates:
DateEvent
March 2020Published
2 January 2020Published Online
17 December 2019Accepted
Publisher License: Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0
URI: http://openaccess.sgul.ac.uk/id/eprint/111641
Publisher's version: https://doi.org/10.1016/j.jinf.2019.12.008

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