Methods: Since October-2005 until September-2014, prospective active surveillance for MeD in children < 16 years old (yo) was performed in the Tijuana, Mexico, General Hospital (TGH). For all N. meningitidis isolates serogroup identification was performed by the Pastorex meningitis kit (Alere, Ltd®, Stockport, UK). Descriptive and comparative analysis was performed using Excel® and VassarStat®. Patients < 16yo during the 2013 outbreak and admitted at TGH (n=6) were not included.
Results: A total of 38 MeD cases were diagnosed. Median age was 2.5 yo (3 months – 15 yo), two patients had a predisposing condition, one patient had been vaccinated with the 4MCV (developed a serogroup B MeD), all patients lived in Tijuana, however, 10 (26.3%) often crossed the Tijuana-San Diego border. Median days of presentation was 2 (hrs – 14), Purpura was present in 16 (42.1%) and Meningitis in 36 (94.5%). N. meningitidis was the leading cause of culture-confirmed Bacterial Meningitis (63.3%, just followed by S. pneumoniae). Serogroup distribution was as follows: C: 22 (57.9%), Y: 10 (26.3%), B: 4 (10.5%), and Unknown: 2 (5.26%). Overall mortality was of 10 (26.3%).Thrombocytopenia and prolongation of clotting times at admission were significantly associated with mortality. Sequeale was present in 9 patients (32%), mostly neurological.
Conclusion: 1. MeD in children is endemic in Tijuana, Mexico. 2. Serogroup C was predominant, and both mortality and sequelae were high. 3. Considering these data, and the fact of having a highly lethal MeD outbreak during 2013, vaccination should be seriously considered in the region.
M. L. Volker-Soberanes, None