NEONATAL MENINGITIS IN ENGLAND AND WALES - A REVIEW OF ROUTINE NATIONAL DATA

The objective of this study was to describe trends in neonatal meningi tis in England and Wales during the years 1975-91. Laboratory reports and, for the years 1983-91, data on statutory notifications and deaths from neonatal meningitis were reviewed. The mean annual total of labo ratory reports of neonatal bacterial meningitis 1975-91 was 109 cases (range 69-133) with a slight upward trend apparent in the latter half of the study period. The mean annual number of reports of neonatal vir al meningitis was only 14 cases with no trend apparent. The leading ba cteria isolated were group B streptococci, Escherichia coli, and Liste ria monocytogenes accounting for 34.1%, 28.5%, and 6.8% of reports, re spectively. There was a change in the pattern of causative bacteria fr om 1981 onwards with the group B streptococcus displacing E coli as th e leading cause. With respect to neonatal viral meningitis, echoviruse s and coxsackie viruses accounted for 55.4% and 38.6% of cases, respec tively. Neonatal meningitis was seriously undernotified; the ratio of laboratory reported cases to cases notified ranged from 12:1 in 1985 t o 4:1 in 1989. The annual numbers of deaths ranged from 18 to 39. The laboratory reporting system provided the most useful data on secular t rends and causative organisms for neonatal meningitis. The slight upwa rd trend in the number of reports of bacterial meningitis merits conti nued surveillance.