Risk of Sequelae After Invasive Meningococcal Disease

Invasive meningococcal disease (IMD) is an uncommon but very serious infection that occurs when meningococcal bacteria invade the body from the throat or nose. It usually manifests as meningitis or sepsis. IMD can be treated with antibiotics and prevented through vaccination, but the 5­–15 percent mortality rate remains high.  A vaccine that protects against all serogroups (a group of bacteria which share distinctive structures) does not yet exist.

A high proportion of survivors are affected by sequelae, ranging from 10–20 percent who will have long term disabilities. Voss and colleagues (2022) investigated data from The National Database for Notifiable Infectious Diseases in Denmark to determine whether age, serogroup and/or clinical presentation were associated with sequelae.

A retrospective analysis of 935 cases of IMD was completed to describe the sequelae among survivors of IMD cases from 2005–2020. Sixty-six patients died within 30 days of being confirmed. Thus, the data from 869 survivors is reported. 

Overall, results revealed that 25 percent of IMD survivors experienced one or more sequelae, and there was no association between sequelae and age or serogroup. The five most common sequelae, in order from most prevalent to least, were hearing loss, epilepsy, learning disabilities, headache and loss of vision.  Approximately 35 percent of all cases with reported sequelae experienced hearing loss. 

The authors conclude that routine referral to hearing evaluation should be included in guidelines for treating IMD regardless of clinical presentation. 

Reference

Voss SS, Nielsen J, Valentiner-Branth P. (2022) Risk of sequelae after invasive meningococcal disease. BMC Infectious Diseases 22:148.