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Bacterial meningitis in adults in Iceland, 1995-2010.

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Authors
Thornórðardóttir, Asgerður
Erlendsdóttir, Helga
Sigurðardóttir, Bryndís
Harðardóttir, Hjördís
Reynisson, Ingi Karl
Gottfreðsson, Magnús
Guðmundsson, Sigurður
Issue Date
2014-05

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Citation
Scand. J. Infect. Dis. 2014, 46 (5):354-60
Abstract
Bacterial meningitis is a serious disease with a mortality rate of 15-20% in adults. We conducted a population-based study of bacterial meningitis in adults (≥ 16 y) in Iceland, 1995-2010.
Cases were identified based on positive bacterial cultures from cerebrospinal fluid (CSF) and/or the ICD codes for bacterial meningitis. Medical charts were reviewed and outcomes were assessed using the national population registry. The study period was divided into 2 equal parts, 1995-2002 and 2003-2010, before and after implementation of routine childhood vaccination against serogroup C meningococci, respectively.
In total, 111 episodes occurred in 110 individuals. The most common causative organisms were Neisseria meningitidis (41%) and Streptococcus pneumoniae (30%). Only 30% of the patients presented with the classical symptom triad of fever, neck stiffness, and an altered mental status. The overall incidence was 3.2/100,000 inhabitants/y, and dropped significantly between the first and second halves of the study (p = 0.03). This drop was due to a reduced incidence of N. meningitidis meningitis: 34 and 12 cases in the first and second periods, respectively (p = 0.006). The incidence of meningitis caused by S. pneumoniae remained unchanged. The case fatality rates were 18% and 13% in the first and second halves of the study, respectively (difference not significant).
The incidence of bacterial meningitis has decreased since the implementation of meningococcal C vaccination in 2002. However, the case fatality rate has remained unchanged.
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http://dx.doi.org/ 10.3109/00365548.2014.880184
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Archived with thanks to Scandinavian journal of infectious diseases
ae974a485f413a2113503eed53cd6c53
10.3109/00365548.2014.880184
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