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Decline in pneumococcal meningitis after the introduction of the heptavalent-pneumococcal conjugate vaccine in northern France
F Dubos, I Marechal, M O Husson, C Courouble, M Aurel, A Martinot and the Hospital Network for Evaluating the Management of Common Childhood Diseases Arch. Dis. Child. 2007;92;1009-1012; originally published online 11 Jul2007; doi:10.1136/adc.2007.119891

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ORIGINALARTICLE

Decline in pneumococcal meningitis after the introduction of the heptavalent-pneumococcal conjugate vaccine in northern France
F Dubos, I Marechal, M O Husson, C Courouble, M Aurel, A Martinot, the Hospital Network for Evaluating the Management of Common Childhood Diseases................................................................................................................................... Arch Dis Child 2007;92:1009–1012. doi: 10.1136/adc.2007.119891

See end of article for authors’ affiliations ........................ Correspondence to: Dr F Dubos, Clinique de Pediatrie, Hopital Jeanne de ´ ˆ Flandre, Avenue E. Avinee, ´ 59037 Lille cedex, France; frandubos@wanadoo.fr Accepted 25 June 2007 Published Online First 11 July 2007 ........................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 2000through 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 acapture–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 31to 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 heptavalentpneumococcal conjugate vaccination began in our area.
covered between 79 and 89% of children ,2 years of age.11 The vaccinationschedule uses a four-dose regimen, at 2, 3 and 4 months of age and a booster dose during the second year of life. The impact of the PCV7 on the incidence of meningitis and other invasive pneumococcal diseases has been clearly demonstrated in North America and Australia,12–16 whose vaccination schedules are different from those in France. The aim of this study was to determine whether PCV7...