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The National Bacterial Meningitis Surveillance Study

Walter F. Schlech III, MD; Joel I. Ward, MD; Jeffrey D. Band, MD; Allen Hightower, MS; David W. Fraser, MD; Claire V. Broome, MD

JAMA. 1985;253(12):1749-1754.

Abstract
From 1977 to 1981, 18,642 cases of bacterial meningitis were reported to the Centers for Disease Control. We analyzed data from 27 states with full participation from 1978 through 1981. Hemophilus influenzae was the most frequent cause of bacterial meningitis (48.3%), followed by Neisseria meningitidis (19.6%) and Streptococcus pneumoniae (13.3%). Overall attack rates for males were greater than for females (3.3 v 2.6 cases per 105 population per year). Attack rates were highest in children under 1 year of age (76.7 per 105 population per year). Case-fatality ratios were highest for gram-negative and miscellaneous causes of bacterial meningitis (33.7%) and lowest for meningitis caused by H influenzae (6.0%). Neisseria meningitidis and S pneumoniae meningitis occurred preponderantly during the winter, while H influenzae meningitis had peak activity in the spring and fall. Ampicillin resistance among H influenzae increased from 18.7% in 1978, to 23.9% in 1981. Serogroup B Neisseria meningitidis was the most common serogroup identified during the reporting period (51.1%), followed by serogroup C (22.3%), serogroup Y (5.8%), and serogroup A (4.7%) infections.

(JAMA 1985;253:1749-1754)

Author Affiliations
From the Special Pathogens Branch, Bacterial Diseases Division, Centers for Disease Control, Atlanta. Dr Schlech is now with the Department of Medicine, Dalhousie University Medical School, Halifax, Nova Scotia. Dr Ward is now with the Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, Calif. Dr Band is now with the Department of Medicine, William Beaumont Hospital, Royal Oak, Mich. Dr Fraser is now with Swarthmore College, Swarthmore, Pa.

Footnotes
Reprint requests to Special Pathogens Branch, BDD/CDC, Centers for Disease Control, Atlanta, GA 30333 (Dr Broome).

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