Clinical presentation of meningococcal disease in childhood

Although relatively rare, meningococcal disease represents a global health problem being still the leading infectious cause of death in childhood with an overall mortality around 8%. Menin- gococcal meningitis is the most commonly recognized presenta- tion, accounting for 80% to 85% of all reported cases of menin- gococcal disease (in half of these cases sepsis is also present con- comitantly). The remaining 15-20% of cases are most commonly bloodstream infections only. Meningococcal serogroups A, B, and C account for most cases of meningococcal disease throughout the world. Recently, serogroups W-135 and X (predominantly in Africa) and group Y (in the United States and European countries) have emerged as important disease-causing isolates. Despite recent advances in medical management, the mortality rate of fulminant meningococcemia ranges from 15% to 30%. However, among survivors, 10-30% could have long term sequelae (i.e. sensoneural hearing loss, seizure, motor problems, hydrocepha- lus, mental retardation, and cognitive and behavioral problems). Considering the clinical severity of meningococcal disease, pre- vention represents the first approach for avoiding serious com- plications and possible deaths. The availability of new vaccines able to cover the emerging serotypes including A and Y as well as the availability on the market of new products that could prevent meningococcal B infection represent a great opportunity for the decrease of the burden of this complicated disease. The full article is free available on www.jpmh.or