Modern Trends in Mortality From Meningococcal Disease in Australia

Abstract

Between 1979 and 2006, there were 610 deaths recorded as due to meningococcal disease in Australia. Mortality rates per capita consistently increased on average by 6% per annum between 1979 and 2002, but then fell significantly in 2003, coinciding with the introduction of the meningococcal C conjugate vaccine. In 2002, the mortality rate was 0.24 per 100,000. In the 4 years since, it fell progressively to 0.06 per 100,000. Since the introduction of conjugate Hib and pneumococcal vaccines, meningococcal disease has emerged as the number 1 infectious cause of death in children but conjugate meningococcal C vaccine appears to have greatly reduced total meningococcal disease deaths.

The accuracy of clinical symptoms and signs for the diagnosis of serious bacterial infection in young febrile children: prospective cohort study of 15 781 febrile illnesses

“…8 9 These conditions can be difficult to distinguish from viral infections and benefit from early antibiotic therapy. The consequences of a delayed or missed diagnosis can be serious and, occasionally, fatal 10…”

Immunogenicity of reduced dose priming schedules of serogroup C meningococcal conjugate vaccine followed by booster at 12 months in infants: open label randomised controlled trial

“…The low titres of bactericidal antibodies in infancy and from 2 years of age onwards observed with just a single MenC vaccination at 12 months of age suggest prevention of breakthrough cases in infants and preschool children depend on herd immunity induced by a catch up vaccination campaign that could then be sustained through adolescent boosting. A single MenC toddler dose was successful in controlling MenC disease in the Netherlands,27 Australia,28 and Canada,29 where infants were protected through herd protection induced by an initial catch up campaign targeting older children and adolescents. An alternative, as in the US, is to provide the first MenC dose in adolescence 30.…”

Sequencing paediatric antiretroviral therapy in the context of a public health approach

“…[ 28 ] reported 27% virological failure among children after 24 weeks of first-line, PI-based treatment. The higher failure rate in this cohort may be because children received either ritonavir-boosted lopinavir (LPV/r) or full-dose ritonavir, which is associated with diminished virological response and the emergence of major protease mutations [ 29 ]. Programmatic data, as have to date been reported mainly from South Africa [ 21 , 30 ], will be very valuable in assessing whether the favourable virological suppression rates reported by trials can be achieved in routine ART programmes.…”