Aims: To investigate the incidence of bacterial meningitis and septicemia amongst children in Västerbotten County 1986 – 2005, and also review the clinical presentation of meningitis in the same settings.
Methods: This population-based register study identified cases from two sources: Västerbotten County councils’ data base registers of diseases and the department of laboratory medicine at Umeå University Hospital’s registers of positive cultures. Medical records were reviewed to confirm the diagnosis.
Results: 85 cases of meningitis and 153 cases of septicemia were included. A decrease in incidence of disease caused by H. influenzae and a rise for S. pneumoniae were seen after a vaccine against Hib was included in the general vaccination program in Sweden in 1993. The incidence of N. meningitidis remained stable and low. Significant differences in clinical presentation of meningitis depended on several factors, the most important one being age. Younger children were more ill, but also presented with more diffuse symptoms.
Conclusion: Vaccination against Hib have had a very positive effect on the incidences of disease caused by H. influenzae, hopefully vaccination against S. pneumoniae will have similar effects. General vaccination against N. meningitidis is not justified at this point. Meningitis is a serious condition and clinical presentation varies. Clinicians must be aware of the fact that children can present with varying symptoms and signs depending on age.