Increased Risk for Disabilities After Childhood Bacterial Meningitis

A recent cohort study published in JAMA described the long-term risks of disabilities from a childhood diagnosis of bacterial meningitis. Individuals diagnosed with bacterial meningitis during childhood suggest that exposed individuals may have had an increased risk for long-term disabilities.

Those diagnosed with bacterial meningitis experienced a greater cumulative incidence of all 7 disabilities, with 29.0% (1,052 individuals) exhibiting at least one disability. The most significant absolute risks for disabilities were identified in behavioral and emotional disorders, hearing loss, visual disturbances, intracranial structural injuries, seizures, motor function disorder, and cognitive disabilities.

Featuring the highest adjusted Hazard Ratios (HRs), intracranial structural injuries 26.04 (95% CI, 15.50-43.74), hearing loss 7.90 (95% CI, 6.68-9.33), and motor function disorders 4.65 (95% CI, 3.72-5.80] stood out. In the case of Streptococcus pneumoniae infection, the adjusted HRs for cognitive disabilities, seizures, hearing loss, and motor function disorders were significantly elevated, 7.89 (95% CI, 5.18-12.02 for seizures) compared to Haemophilus influenzae infection 2.46 (95% CI, 1.63-3.70) or Neisseria meningitidis infection 1.38 (95% CI, 0.65-2.93).

This study was conducted on a nationwide scale, and involved individuals under the age of 18 diagnosed with bacterial meningitis. They were matched (1:9) with general population controls based on age, sex, and place of residence. The data were collected from the Swedish National Patient Register from January 1, 1987, to December 31, 2021. Data analysis took place between July 13, 2022, and November 30, 2023.

“Age also appears to be an important risk factor. When we compared the risk of long-term disabilities among children diagnosed at a young (below median) vs older (above median) age conditional on the type of infection, the relative risk of disabilities was numerically higher for children diagnosed at an early age for all types of disabilities and significantly higher for cognitive disabilities, seizures, behavioral and emotional disorders, and intracranial structural injuries. Our interpretation is that the brain and nervous system damage that can follow an episode of bacterial meningitis is more detrimental for young children who are at a sensitive stage in their physical and mental development.”¹

In comparison to previous studies, this research reports a higher risk of disabilities, possibly due to its extended follow-up period and comprehensive disability data. The findings emphasize the importance of childhood vaccinations against bacterial meningitis, particularly caused by S pneumoniae, and highlight the need for follow-up strategies to detect less noticeable disabilities that may go undetected for years.

Vaccine for Meningococcal Disease

According to Centers for Disease Control and Prevention (CDC), this vaccine safeguards against the bacteria responsible for meningococcal disease, offering protection from infections affecting the brain and spinal cord lining, as well as bloodstream infections. Additionally, it helps prevent long-term disabilities commonly associated with surviving meningococcal disease.

“Meningococcal meningitis and bloodstream infections can be very serious, even deadly. The infections progress quickly. Someone can go from being healthy to very ill in 48 hours or less,” according to the CDC. “Even if they get treatment, about 10 to 15 in 100 people with meningococcal disease will die from it. Up to 1 in 5 survivors will have long-term disabilities, including loss of limbs, deafness, nervous system problems, and brain damage.”²

References

1. Mohanty S, Johansson Kostenniemi U, Silfverdal SA, et al. Increased risk of long-term disabilities following childhood bacterial meningitis in Sweden. JAMA Netw Open. 2024;7(1):e2352402. doi:10.1001/jamanetworkopen.2023.52402
2. CDC Healthy schools. CDC. Published June 28, 2019. Accessed January 22, 2024. https://www.cdc.gov/healthyschools/bam/diseases/meningitis.htm