Mumps vaccination, PCR testing for specific viruses and more sensitive clinical management techniques significantly reduced hospital admission rates for viral meningitis among children in the United Kingdom during the past 50 years, according to recent study findings.
“Long-term trends in hospital admission for viral meningitis in children in England have not previously been reported,” Natalie G. Martin, MBChB, a clinical research fellow at the Oxford Vaccine Group in the department of pediatrics, University of Oxford, and colleagues wrote. “Improved knowledge of the epidemiology and true burden of hospital admissions is important to inform future research into prevention through vaccination, improved rapid diagnostic techniques, clinical management guidelines and as the basis for health care cost-effectiveness analyses.”
To measure epidemiological trends in childhood viral meningitis in England, Martin and colleagues collected hospital discharge records to quantify viral meningitis occurrences spanning 5 decades in a population-based observational study. The researchers analyzed admission rates in children aged younger than 15 years, including viral etiologies.
The average annual hospital admission rate for viral meningitis from 1968 through 1985 was 13.5 per 100,000 children (95% CI, 13-14) in the cohort, with those aged 1 to 14 years comprising 89% of the 24,920 admissions. From 1989 through 2011, the average rate decreased significantly to 5.2 per 100,000 per year (95% CI, 5.1-5.3) in patients aged 1 to 14 years. Research showed that from 2007 through 2011, 72% of the 2,382 cases were among infants aged younger than 1 year. Data indicated a 13% increase in cases from 2005 to 2011 when 70 per 100,000 infants (95% CI, 63.7-76.2) were hospitalized with viral meningitis. The investigators said this rise was driven by patients aged 90 days or younger.
The researchers attributed the overall decline in mumps-related meningitis to the advent of the measles-mumps-rubella vaccine in 1988.
“The great majority of cases of viral meningitis in hospital statistics, both historically and in recent years, are recorded without a specific virus type,” Martin and colleagues wrote. “It is therefore difficult to be precise about the etiological components of the decline.
“The reasons behind the changing trends, especially the cause of the increase in infant viral meningitis admissions, warrants further investigation, including prospective cohort studies to direct strategies to improve infant health.” – by Kate Sherrer
Disclosure: Martin reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.