National Analysis of Bacterial Meningitis Slovakia, 1997–2007

This article by Hudeckova et al. provides a very interesting look at causation and disease patterns of bacterial meningitis in Slovakia, a small country of about five million people with one of the fastest-growing economies in Eastern Europe.The authors were able to analyze and compare retrospectively the mortality and morbidity rates of bacterial meningitis during two periods of time : 1997-2001 and 2002-2007.This analysis was facilitated by the requirement for obligatory vaccination of infants against invasive infections caused by Haemophilus influenzae type b (Hib) in 2000.This "natural experiment" provided evidence of the value of comprehensive and obligatory vaccination programs.As the authors note, the improvement of the epidemiologic situation of bacterial meningitis caused by Hib was seen most dramatically in children younger than 4 years of age-in other words, those who are most susceptible to this pathogen.Their results follow findings in other developed countries.In 2003, Sáez-Llorens and McCracken found that the beginning of this millennium has witnessed the virtual disappearance of Haemophilus invasive disease in some countries, emergence of pneumococcal strains that are resistant to multiple antibiotics, isolation of pneumococci with tolerance to vancomycin, outbreaks and clusters of meningococcal meningitis in several geographic areas, and intense research in the development of effective conjugate pneumococcal and meningococcal vaccines. 1 In April 2009, British Department of Health Director of Immunization David Salisbury commented that since the Hib vaccine was introduced in 1992, cases of bacterial meningitis have dropped by 99%-from about 800 cases a year to a record low of 12 cases in 2008 in children younger than 5 years of age. 2 The work reported from Slovakia and other locations reinforces the importance of basic public health measures in improving the overall quality of life for a particular country's citizens.In Slovakia and many other locations, Hib is the leading cause of bacterial meningitis and other invasive bacterial disease among children younger than 5 years of age.