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Mortality in meningococcal disease: please report the figures accurately
  1. R Booy
  1. Department of Paediatrics, Imperial College School of Medicine, St Mary's Hospital, Norfolk Place, London W2 1PG, UK; r.booy{at}

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We thank Tibby and colleagues for their interest. We believe they and others would be interested in the accompanying figure (see above).

It compares yearly case fatality rates on all referrals to St Mary’s PICU, regardless of whether they died before a mobile intensive care team arrived or while the team was assisting with resuscitation. The 29 “outside” deaths are included (3 in 1992/3, 8 in 1994, 10 in 1995, 3 in 1996, 5 in 1997). As stated in our published paper, logistic regression analysis, controlling for disease severity, age and sex, and including these extra deaths, showed no change in the estimated odds ratio for the yearly reduction in death rate, namely 0.41. The overall case fatality rate for 1997 became 6% compared with the PICU admission rate of 2% and a predicted case fatality rate 34% using PRISM scores.

For the 5 deaths in 1997 outside St Mary’s PICU, response times between call to the unit and arrival of a team at the DGH varied between 100 and 185 minutes. One child died as the local hospital were telephoning us, two arrested within 90 minutes of St Mary’s being called and died within minutes of the team arriving, and the other two died between 2 and 7 hours after arrival.


Actual and predicted annual case fatality rates.

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