Davis KL, Candrilli S. Recent trends in incidence and demographics of pediatric meningococcal disease in the United States. Poster presented at the 2013 ISPOR 16th Annual European Congress; November 2013. [abstract] Value Health. 2013 Nov; 16(7):A342.

OBJECTIVES: Approximately 1,000-1,200 people in the United States (US) develop meningococcal disease (MD) each year. MD is a life-threatening bacterial infection most common in infants (age < 1 year), adolescents, and persons living in close quarters. We estimated annual incidence and demographic characteristics of MD in the US pediatric population from 2000 to 2009.

METHODS: Data for pediatric (age ≤ 20 years) MD-related hospitalizations (discharges with ICD-9-CM 036.xx) from the 2000, 2003, 2006, and 2009 HCUP Kids’ Inpatient Databases (KID) were retrospectively analyzed. Annual MD incidence per 100,000 pediatrics (adjusted to 2010 US population) was estimated using KID sampling weights and year-specific population denominators from US census data.

RESULTS: Pediatric MD incidence steadily decreased from 1.9/100,000 in 2000 to 0.7/100,000 in 2009, a 63% decline. Incidence was highest, by far, in infants, which also decreased during 2000-2009 (7.6/100,000 to 3.8/100,000, a 50% decline). Among children aged 1-4 years, incidence fell from 2.7/100,000 to 0.8/100,000 during this period, a 70% decline. In children aged 5-10 years, we observed a 75% decline (1.2/100,000 to 0.3/100,000); similar incidence and trends were seen for age groups 11-18 and 19-20 years. Pediatric MD cases were predominantly male, with male representation increasing from 55% to 61% of cases during 2000-2009. The racial composition of pediatric MD shifted somewhat during this period, with representation declining among whites (from 56% to 45% of cases) and increasing among blacks (from 8% to 11% of cases). Geographic distribution remained fairly constant, with highest representation from the South (~30% of cases) and West (~30% of cases).

CONCLUSIONS: Pediatric MD incidence declined during the 2000’s, possibly due to the introduction of the meningococcal conjugate vaccine in 2005. However, MD incidence remained substantially higher in infants compared with other age groups and there appeared to be a demographic shift in cases away from females and whites.