Epidemiology of Meningitis and Encephalitis in Infants and Children in the United States, 2011-2014

Rodrigo Hasbun, Susan H Wootton, Ning Rosenthal, Joan Miquel Balada-Llasat, Jessica Chung, Steve Duff, Samuel Bozzette, Louise Zimmer, Christine C. Ginocchio

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Large epidemiologic studies evaluating the etiologies, management decisions and outcomes of infants and children with meningitis and encephalitis in the United States are lacking. METHODS: Children 0-17 years of age with meningitis or encephalitis as assessed by International Classification of Diseases, Ninth Revision, codes available in the Premier Healthcare Database during 2011-2014 were analyzed. RESULTS: Six thousand six hundred sixty-five patients with meningitis or encephalitis were identified; 3030 (45.5%) were younger than 1 year of age, 295 (4.4%) were 1-2 years of age, 1460 (21.9%) were 3-9 years of age, and 1880 (28.2%) were 10-17 years of age. Etiologies included enterovirus (58.4%), unknown (23.7%), bacterial (13.0%), noninfectious (3.1%), herpes simplex virus (1.5%), other viruses (0.7%), arboviruses (0.5%) and fungal (0.04%). The majority of patients were male [3847 (57.7%)] and healthy [6094 (91.4%)] with no reported underlying conditions. Most underwent a lumbar puncture in the emergency department [5363 (80%)] and were admitted to the hospital [5363 (83.1%)]. Antibiotic therapy was frequent (92.2%) with children younger than 1 year of age with the highest rates (97.7%). Antiviral therapy was less common (31.1%). Only 539 (8.1%) of 6665 of patients received steroids. Early administration of adjunctive steroids was not associated with a reduction in mortality (P = 0.266). The overall median length of stay was 2 days. Overall mortality rate (0.5%) and readmission rates (<1%) was low for both groups. CONCLUSION: Meningitis and encephalitis in infants and children in the United States are more commonly caused by viruses and are treated empirically with antibiotic therapy and antiviral therapy in a significant proportion of cases. Adjunctive steroids are used infrequently and are not associated with a benefit in mortality.

LanguageEnglish
Pages37-41
Number of pages5
JournalThe Pediatric infectious disease journal
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2019

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Encephalitis
Meningitis
Epidemiology
Steroids
Antiviral Agents
Mortality
Anti-Bacterial Agents
Viruses
Arboviruses
Spinal Puncture
Enterovirus
International Classification of Diseases
Simplexvirus
Therapeutics
Hospital Emergency Service
Epidemiologic Studies
Length of Stay
Databases
Delivery of Health Care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Hasbun, R., Wootton, S. H., Rosenthal, N., Balada-Llasat, J. M., Chung, J., Duff, S., ... Ginocchio, C. C. (2019). Epidemiology of Meningitis and Encephalitis in Infants and Children in the United States, 2011-2014. The Pediatric infectious disease journal, 38(1), 37-41. https://doi.org/10.1097/INF.0000000000002081

Epidemiology of Meningitis and Encephalitis in Infants and Children in the United States, 2011-2014. / Hasbun, Rodrigo; Wootton, Susan H; Rosenthal, Ning; Balada-Llasat, Joan Miquel; Chung, Jessica; Duff, Steve; Bozzette, Samuel; Zimmer, Louise; Ginocchio, Christine C.

In: The Pediatric infectious disease journal, Vol. 38, No. 1, 01.01.2019, p. 37-41.

Research output: Contribution to journalArticle

Hasbun, R, Wootton, SH, Rosenthal, N, Balada-Llasat, JM, Chung, J, Duff, S, Bozzette, S, Zimmer, L & Ginocchio, CC 2019, 'Epidemiology of Meningitis and Encephalitis in Infants and Children in the United States, 2011-2014', The Pediatric infectious disease journal, vol. 38, no. 1, pp. 37-41. https://doi.org/10.1097/INF.0000000000002081
Hasbun, Rodrigo ; Wootton, Susan H ; Rosenthal, Ning ; Balada-Llasat, Joan Miquel ; Chung, Jessica ; Duff, Steve ; Bozzette, Samuel ; Zimmer, Louise ; Ginocchio, Christine C. / Epidemiology of Meningitis and Encephalitis in Infants and Children in the United States, 2011-2014. In: The Pediatric infectious disease journal. 2019 ; Vol. 38, No. 1. pp. 37-41.
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