Which preventive measures have decreased the incidence of bacterial meningitis in the US?

Updated: Jul 16, 2019
  • Author: Rodrigo Hasbun, MD, MPH; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Previously, Hib, N meningitidis, and S pneumoniae accounted for more than 80% of cases of bacterial meningitis. Since the late 20th century, however, the epidemiology of bacterial meningitis has been substantially changed by multiple developments.

The overall incidence of bacterial meningitis in the US declined from 2.0 to 1.38 cases per 100,000 population between 1998 and 2007. [5] This was partially because of the widespread use of the Hib vaccination, which decreased the incidence of H influenzae meningitis by more than 90% (see Table 3 below). Routine Hib vaccination has nearly eliminating this pathogen as a cause of meningitis in many developed countries.

More recent prevention measures such as the pneumococcal conjugate vaccine and universal screening of pregnant women for GBS have further changed the epidemiology of bacterial meningitis.

Table 3. Changing Epidemiology of Acute Bacterial Meningitis in United States* (Open Table in a new window)

Bacteria

1978-1981

1986

1995

1998-2007

Haemophilus influenzae

48%

45%

7%

6.7%

 

Listeria monocytogenes

2%

3%

8%

3.4%

 

Neisseria meningitidis

20%

14%

25%

13.9%

 

Streptococcus agalactiae (group B streptococcus)

3%

6%

12%

18.1%

 

Streptococcus pneumoniae

13%

18%

47%

58%

 

*Nosocomial meningitis is not included; these data include only the 5 major meningeal pathogens.

 

 


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