Population-Based Surveillance for Invasive Bacterial Diseases in East Asian Children: Interim Results from Korea, 1999-2000

Kim JS ¹, Kim JD², Chang³, Kilgore PE⁴, Kennedy WA⁵, Ward JI⁵, Clemens JD⁴

¹Chonbuk National University Hospital, ²WonKwang University Hospital, ³Chonju Presbyterian Medical Center, Chonju, Korea; ⁴International Vaccine Institute, Seoul, Korea; ⁵UCLA Center for Vaccine Research, Torrance, U.S.A.

Objectives: To determine the incidence of H. influenzae type b (Hib), S. pneumoniae (Sp), N. meningitidis(Nm) bacterial meningitis and other invasive diseases in Korean children < 5 years of age.

Methods: Active surveillance for bacterial meningitis has been conducted in Chonbuk province infants and children aged < 5 years (population of 124,503) from Sept 1999-July 2000. Patients were evaluated using standardized clinical and microbiologic evaluations to determine the presence of bacterial meningitis and other invasive bacterial diseases.

Results: The bacterial etiology of meningitis in children from this province amongst 19 cases of 611 evaluated children, were Hib (7,37%), Sp (3,16%), Group B Streptococcus (GBS) (6,32%) and other bacteria (3,16%). Bacteremia occurred in 2 patients with Hib and 1 patient with GBS. The crude Hib meningitis incidence rate was 6.1 cases/100,000 child-years and the incidence for all invasive Hib disease was 7.9 cases/100,000 child-years. In Chonju City, the overall incidence of all invasive Hib disease was 14.5 cases per 100,000 child-years. After adjusting for factors that influence detection of Hib disease, the incidence of all invasive Hib disease in Chonbuk was 14 cases per 100,000 child-years.

Conclusions: These results indicate that Hib, Sp and GBS cause bacterial meningitis among infants and children aged < 5 years. While the incidence of meningitis due to Hib appears lower than determined for North America, important factors exist that may explain this lower incidence and may be used to determine an adjusted incidence of Hib meningitis.

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