Surveillance of bacterial meningitis in children under 2 y of age in Denmark, 1997-2006

Worldwide the 3 most common pathogens for bacterial meningitis among infants and young children are Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis. Denmark included in the National Childhood Vaccination Programme vaccination against H. influenzae type B (Hib) in 1993 and invasive pneumococcal disease as of October 2007. Introduction of the conjugated heptavalent pneumococcal vaccine is, as in the post-Hib vaccination era, expected to change the epidemiology of bacterial meningitis in infants and young children. In 1980 it became mandatory to report suspected cases of bacterial meningitis and the surveillance system was further enhanced for laboratory diagnosed cases of N. meningitis in 1992 and S. pneumoniae in 1996 when a reminder procedure to the physician was issued. In this article we review the epidemiology of 418 notified cases of bacterial meningitis in children <2 y of age in Denmark in the pre-pneumococcal vaccination era 1997-2006 and discuss points of awareness for the future surveillance system.