§ Mr. Jon Owen JonesTo ask the Secretary of State for Health if he will list the geographical position and size of bacterial meningitis clusters occurring in each month over the last five years. [7678]
§ Mr. HoramEnhanced surveillance of clusters of suspected meningococcal infection was instigated in April 1995. Collation of retrospective data on clusters reported before this time is incomplete. Data on the number of cases associated with clusters by region and month are shown in the tables. The definition of a cluster for reporting is
two or more suspected cases occurring within onset of one month in the same educational setting".In 1996, up to the end of October, 27 clusters were reported involving a total of 94 cases. Many of these cases are not confirmed by laboratory tests. Cases associated with clusters have therefore formed a very small proportion of all cases reported this year.
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Invasive meningococcal infection reports Numbers of clusters (and cases) by region, May to December 1995 Regions May June July August September October November December Anglia and Oxford — — — — — — 1 (5) 2 (5) Northern and Yorkshire — — — — — — 4 (15) 3 (7) North Thames — — — — — — — — North West — — — — — — — 1 (2) South Thames — — — — — — 1 (2) 1 (3) South and West 1 (2) — — — — — — 1 (2) Trent — — — — — — 1 (3) — West Midlands — — — — — 2 (4) 1 (2) — Wales — — — — — 1 (2) — — Total 1 (2) — — — — 3 (6) 8 (27) 8 (19) A cluster is defined as two or more suspected cases with onset within one month in the same educational setting. Numbers in brackets indicate the number of cases. Prepared by the immunisation division, CDSC to 3 December 1996.
Invasive meningococcal infection reports Numbers of clusters (and cases) by region, January to October 1996 Regions January February March April May June July August September October Anglia and Oxford — 1 (2) — — — — — — — — Northern and Yorkshire 2 (10) 2 (7) 1 (2) 1 (2) — — — — — — North Thames 1 (2) — 1 (2) — 2 (18) — — — — — North West — — — — 1 (2) — — — — 1 (2) South Thames — — 1 (2) 2 (8) — — — — — — South and West 1 (3) 3 (6) 1 (2) — — — 1 (3) — — — Trent 1 (8) — — 2 (4) — — — — — — West Midlands — — — — — 1 (7) — — — 1 (2) Wales — — — — — — — — — — Total 5 (23) 6 (15) 4 (8) 5 (14) 3 (20) 1 (7) 1 (3) — — 2 (4) A cluster is defined as two or more suspected cases with onset within one month in the same educational setting. Numbers in brackets indicate the number of cases. Prepared by the immunisation division, CDSC to 3 December 1996.
§ Mr. JonesTo ask the Secretary of State for Health if he will list those factors that his Department has evaluated as potentially enhancing the transmission of bacterial meningitis. [7674]
§ Mr. HoramMeningococcal infection—meningitis and septicaemia—occurs throughout the year but infections reach a peak in the winter months. Research suggests that risk factors for meningitis include smoking, passive smoking, damp and other prevalent infections such as influenza. Group C infections are more likely in closed and semi-closed communities.
§ Mr. JonesTo ask the Secretary of State for Health if he will list the recent cases of bacterial meningitis involving students(a) living in halls of residence and (b) attending colleges, universities and schools. [7675]
§ Mr. HoramDetailed data on single cases of confirmed meningococcal infection occurring in schools, universities and colleges are not collated at a national level. From the age distribution of confirmed cases reported in 1996, 161–13 per cent.—of cases have occurred in school-age children and 278–22 per cent.—have occurred in young adults aged 15 to 24 years—many of whom will be in full-time education. Nearly one half of all cases still occur in children under five years of age.
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§ Mr. JonesTo ask the Secretary of State for Health what criteria his Department uses to determine whether an individual is part of a high-risk group when notified of a case of meningitis. [7676]
§ Mr. HoramPersons at highest risk of meningococcal disease include infants and pre-school children with a second smaller incidence occurring in adolescence. Some persons with specific immunological disorders may also be at increased risk.
People with prolonged close—household type—contact or intimate contact with an individual with the infection are at increased risk of disease compared with other persons in the community. Risk to persons with other types of contact with cases is low, but after two or more cases in the same place, for example a school, within four weeks a local assessment of risk may be performed and the definition of "high risk" group extended. This guidance is outlined in the Public Health Laboratory Service publication, "PHLS Meningococcal Infections Working Group and Public Health Medicine Environment Group. Control of meningococcal disease: guidance for consultants in communicable disease control" (communicable disease report 1995; 5: R189–195) copies of which are available in the Library.