Invasive meningococcal disease: Timing and cause of death in England, 2008–2015

Kazim Beebeejaun, Sydel R. Parikh, Helen Campbell, Steve Gray, Raymond Borrow, Mary Ramsay, Shamez Ladhani*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)


Background: Neisseria meningitidis is a major cause of bacterial meningitis and septicaemia, with death often occurring rapidly after onset of the first symptoms. Later death can also occur, but may be due to other causes, such as underlying comorbidities. The study aimed to assess the timing and cause of death in patients with invasive meningococcal disease (IMD) prior to the introduction of two new meningococcal immunisation programmes in England. 

Methods: Public Health England (PHE) conducts IMD surveillance in England through its national meningococcal reference unit. Laboratory-confirmed IMD cases diagnosed during 2008–2015 were linked to weekly and annual electronic death registration records as well as the Patient Demographic Service (PDS) database. 

Results: Overall, 6734 of 6808 (99%) laboratory-confirmed IMD cases matched to PDS, including 668 fatalities. Of these, 667 linked to an annual death registration record compared to 405 reports linked to weekly death registrations. In total, 429/667 (64%) of all deaths and 428/502 (85%) of IMD-related deaths occurred within one day of diagnosis. In total, 498/667 (75%) deaths had occured by 30 days after IMD diagnosis and 98% (490/498) of these were IMD-related. Serogroup B contributed to 64% (323/502) of IMD-related deaths, followed by serogroup W (84/502, 17%) and serogroup Y (70/502, 14%). Deaths occurring after 30 days were less likely to be IMD-related, mainly amongst ≥65 year-olds, with malignancy, chronic respiratory and cardiac conditions predominating. 

Conclusions: Most IMD-related deaths occurred within a day of diagnosis and nearly all IMD-related deaths occurred within 30 days of diagnosis. The rapidity of death highlights the importance of prevention through vaccination.

Original languageEnglish
Pages (from-to)286-290
Number of pages5
JournalJournal of Infection
Issue number3
Early online date2 Jan 2020
Publication statusPublished - Mar 2020

Bibliographical note

Funding Information: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Open Access: No Open Access licence.

Publisher Copyright: © 2019 Published by Elsevier Ltd on behalf of The British Infection Association.

Citation: Kazim Beebeejaun, Sydel R. Parikh, Helen Campbell, Steve Gray, Ray Borrow, Mary E. Ramsay, Shamez N. Ladhani, Invasive meningococcal disease: Timing and cause of death in England, 2008–2015, Journal of Infection, Volume 80, Issue 3, 2020, Pages 286-290, ISSN 0163-4453.



  • Case fatality rate
  • Cause
  • Death
  • Meningococcal disease
  • Serogoup


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