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Decline in pneumococcal meningitis after the introduction of the heptavalent-pneumococcal conjugate vaccine in northern France
  1. F Dubos1,
  2. I Marechal1,
  3. M O Husson2,
  4. C Courouble3,
  5. M Aurel1,
  6. A Martinot1
  1. 1
    Paediatric Emergency and Infectious Diseases Unit, Department of Paediatrics, Jeanne de Flandre Hospital and Lille-2 University, Lille, France
  2. 2
    EA 3925, Department of Microbiology, Bâtiment Paul Boulanger and Lille-2 University, Lille, France
  3. 3
    Regional Department of Medical Information, Dr Schaffner Hospital, Lens, France
  1. Dr F Dubos, Clinique de Pédiatrie, Hôpital Jeanne de Flandre, Avenue E. Avinée, 59037 Lille cedex, France; frandubos{at}


Background: The impact of the heptavalent-pneumococcal conjugate vaccine on the incidence of pneumococcal meningitis in Europe has not yet been assessed.

Objective: To determine whether heptavalent-pneumococcal conjugate vaccine implementation in northern France has resulted in a decrease in the incidence of pneumococcal meningitis in children.

Design: Multicentre retrospective cohort study from 2000 through 2005.

Settings: All paediatric departments of the 18 hospitals in northern France.

Patients: Patients <18 years of age, admitted for laboratory-confirmed pneumococcal meningitis during the study period, were included.

Interventions: Data were collected from medical files and the microbiological laboratories of each hospital and compared with the regional hospital discharge codes, using a capture–recapture method.

Main outcome measures: The study assessed and compared global and age-related incidence rates of pneumococcal meningitis in 2001 (pre-vaccine era) and 2005.

Results: 77 cases were found through the capture–recapture method. The incidence rate of pneumococcal meningitis varied from 1.65/100 000 children <18 years in 2001 to 0.80/100 000 children in 2005 (53% reduction, 95% CI 31 to 74; p = 0.08). This has so far been significant only for children <2 years of age (8.9/100 000 in 2001 to 1.8/100 000 in 2005; 82% reduction, 95% CI 52 to 95; p = 0.03).

Conclusion: A decline in pneumococcal meningitis has been observed in infants since heptavalent-pneumococcal conjugate vaccination began in our area.

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  • Funding: None.

  • Competing interests: None.

  • Abbreviations:
    cerebrospinal fluid
    white blood cell