012 - CLINICAL CHARACTERISTICS OF CHILDREN UNDER 16 YEARS OF AGE WITH PNEUMOCOCCAL MENINGITIS IN THE UK AND IRELAND: A PROSPECTIVE OBSERVATIONAL STUDY, 2020-2022 (ID 659)
Abstract
Background
Streptococcus pneumoniae is a major cause of bacterial meningitis globally and is associated with high morbidity and mortality. We conducted enhanced national surveillance of pneumococcal meningitis to describe the clinical profile and estimate incidence of pneumococcal meningitis in children aged under 16 years in the United Kingdom and Ireland.
Methods
From 1 January 2020 to 31 January 2022 clinicians were asked to report cases of pneumococcal meningitis to the British Paediatric Surveillance Unit and complete an online questionnaire. Serotype information was supplemented by national pneumococcal surveillance data from the UK Health Security Agency.
Results
Of the 56 cases, almost half were aged <1 year (25/55, 46%), while 31% were aged 1-4 years (n=17). Most children had no known comorbidities (30/41; 73.2%). Cases due to serotypes included in PPV23 but not in PCV13 (28/43; 65%) predominated, followed by non-vaccine serotypes (NVT; n=12, 27.9%). Meningitis caused by vaccine serotypes were rare (1 PCV7 2.3%; 2 PCV13, 4.7%) All cases were hospitalised and half (19/38) required intensive care. Five children died within 28 days of infection (5/56, 9%). Estimated incidence in England was 0.4/100,000 children (95%CI, 0.3-0.6) and higher in under 1 year-olds (3.8/100,000; 95%CI, 2.4-5.7). Incidence rates in Wales, Scotland, Northern Ireland and Ireland were 0.70, 0.22, 0.25 and 0.09 per 100,000, respectively.
Conclusions
Pneumococcal meningitis cases were mostly due to serotypes not included in pneumococcal conjugate vaccines. The incidence was low in all nations, although this estimate will have been impacted by the decrease in pneumococcal disease due to the COVID-19 pandemic.
