Updating Information About the Burden of Meningococcal Disease Hospitalisations in Spain

Introduction Meningococcal disease remains an important public health problem worldwide due to its high lethality and high sequelae rates. Although meningococcal disease shows a decreasing incidence trend, vaccination against the current predominant serogroup (serogroup B) in Europe is not offered by routine in Spain and continuous surveillance is needed. Methods Meningococcal disease (ICD-9: 036 codes in any diagnosis listed position) hospitalisations from 1997 to 2013 were obtained from the Spanish National Registry of Hospitalisations. Number of hospitalisations and deaths, hospitalisation and death rates, case fatality rates and average length of hospital stay were calculated for all meningococcal disease hospitalisations and for the main clinical presentations, meningitis and meningococcemia. Data on number of hospitalisations were compared to cases reported to the National Surveillance System. Results Between 1997 and 2013, there were 14,069 hospital discharges due to meningococcal disease. Of them, 13,267 (94.30%) were first hospitalisations and 802 (5.70%) readmissions/transfers. Most common clinical presentation were meningococcemia alone (41.04%; 5,774 hospitalisations), followed by meningitis alone (39.61%; 5,573 hospitalisations). Both clinical presentations appeared together in 1,885 (13.40%) hospitalisations. Hospitalisation rates decreased (p<0.001) from 1997 to 2013 from 3.98 to 0.65; from 1.65 to 0.25; and from 2.23 to 0.27 hospitalisations per 100,000 population for meningococcal disease, meningitis and meningococcemia, respectively. Case fatality rate was 7.31% for all, 3.88% for meningitis and 9.56% for meningococcemia. Meningococcemia showed higher hospitalisation and death rates in 1-4 and 5-14 age-groups (p<0.001) and higher case fatality rate in all age-groups (p<0.001) than meningitis. Average length of stay was 11.46 days. High concordance (98%) among the National Surveillance System and the National Registry of Hospitalisation was found. Serogroup B cases notified decreased from 458 in 1997 to 193 cases in 2013. Discussion Meningococcemia is the most frequent clinical presentation in Spain with higher hospitalisation and death rates in the youngest groups and higher case fatality rates than the other predominant clinical presentation, meningitis. Meningococcal disease shows a decreasing trend and serogroup B cases decreased by 58% from 1997 to 2013 in absence of vaccination. Citation: Ordóñez-León GY, Martínez EV, Herruzo R, Garrido-Estepa M (2016) Updating Information About the Burden of Meningococcal Disease Hospitalisations in Spain. J Vaccines Res Vaccin 2: 003.