Population-based Surveillance for Bacterial Meningitis in China, September 2006–December 2009 - Volume 20, Number 1—January 2014 - Emerging Infectious Disease journal - CDC
Volume 20, Number 1—January 2014
Population-based Surveillance for Bacterial Meningitis in China, September 2006–December 2009
Bacterial meningitis continues to be a major cause of illness and death in neonates and children throughout the world (1). The leading vaccine-preventable causes of this disease areStreptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b (Hib). The increasing availability of vaccines has made public health initiatives to control bacterial meningitis disease feasible; however, the incidence of this disease and associated deaths in resource-limited countries continue to exceed those for developed countries (2). Accurate pathogen-specific estimates of the number of bacterial meningitis cases are needed to monitor and refine vaccination programs, but such estimates are challenging to obtain in many countries because of limited laboratory-based surveillance capacity.
Thirty-nine infectious diseases are currently routinely reportable in China. However, among the common bacterial meningitis pathogens, only epidemic meningitis caused by N. meningitidis is reportable (3,4). Most reported cases of epidemic meningitis represent clinical diagnoses that lack laboratory confirmation because of the low culture rate for N. meningitidis.
In population-based studies, the incidence of acute bacterial meningitis in China ranges from 12.4 to 19.2 cases/100,000 children < 5 years of age (5,6). Available studies suggest that the main causal pathogens of bacterial meningitis in China are N. meningitidis, Hib, and S. pneumoniae (7–9). In population-based studies in Hefei and Nanning, China, the incidence of meningitis caused by Hib was 10.66 and 0.98 cases/100, 000 children < 5 years of age, respectively (6,10), and the incidence of S. pneumoniae meningitis was 1.5 and 1.3 cases/100,000 children < 5 years of age, respectively (6,11).
In 2006, the Acute Meningitis and Encephalitis Syndrome Project was initiated in China (12,13) to determine the incidence and epidemiology of vaccine-preventable causes of meningitis and encephalitis and to improve the laboratory capacity for diagnosis of these diseases. Using data from the project’s active surveillance system, we report the etiology, epidemiology, and estimated incidence of bacterial meningitis in 4 Chinese prefectures during September 2006–December 2009.
We thank Steve McLaughlin, Lisa Lee, Daxin Ni, and Junfeng Yang. We are grateful for the contributions of the staff at the Chinese CDC; the Shandong, Hubei, Hebei, and Guangxi provincial CDCs; the Jinan, Yichang, Shijiazhuang, and Guigang Prefecture CDCs; the county CDCs, and the clinical doctors and patients whose support and participation made this project successful.
Financial support was provided by the Acute Meningitis–Encephalitis Syndrome Surveillance project of US Centers for Disease Control and Prevention’s Global Disease Detection and Response Initiative.
Dr Yixing Li is a professor at National Immunization Programme, Chinese CDC, and her research interests include meningitis and encephalitis disease epidemiology and the use of vaccines.
Suggested citation for this article: Li Y, Yin Z, Shao Z, Li M, Liang X, Sandhu HS, et al.; the Acute Meningitis and Encephalitis Syndrome Study Group. Population-based surveillance for bacterial meningitis in China, September 2006–December 2009. Emerg Infect Dis [Internet]. 2014 Jan [date cited]. http://dx.doi.org/10.3201/eid2001.120375
1These authors contributed equally to this article.
2Members of the Acute Meningitis and Encephalitis Syndrome Study Group are listed at the end of this article.