Long-term Impact of Invasive Meningococcal Disease in Australian Adolescents and Young Adults

Mark McMillan^{1

2}, Jim Buttery^{3

4}, Margaret Angliss³, Belinda Barton^{5

6}, Artemis Synn⁷, Christopher C Blyth^{8

9

10}, Robert Booy¹¹, Suja M Mathew¹, David Shaw¹², David Gordon^{13

14}, Shalem Leemaqz¹⁵, Morgyn Warner¹², Renjy Nelson¹², Rory Hannah¹⁶, Naomi Runnegar¹⁷, Allen C Cheng¹⁸, Helen S Marshall^{1

2}

Affiliations

¹ From the Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network.
² Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia.
³ Department of Infection and Immunity, Monash Children's Hospital, Melbourne.
⁴ Department of Paediatrics, University of Melbourne, Parkville, Victoria.
⁵ CHERI, The Children's Hospital at Westmead, Westmead.
⁶ Psychological Sciences, Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales.
⁷ Northern Adelaide Local Health Network, Adelaide, South Australia.
⁸ Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia.
⁹ School of Medicine, University of Western Australia.
¹⁰ Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia.
¹¹ University of Sydney, Camperdown, New South Wales.
¹² Infectious Disease Unit, Central Adelaide Local Health Network.
¹³ Department of Microbiology and Infectious Diseases, Flinders Medical Centre.
¹⁴ College of Medicine and Public Health, Flinders University, Adelaide.
¹⁵ South Australian Health and Medical Research Institute, Women's and Children's Hospital, North Adelaide.
¹⁶ Infectious Diseases, Clinical Immunology and Allergy Division, Medicine Lyell McEwin Hospital, Adelaide, South Australia.
¹⁷ Infectious Management Services, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland.
¹⁸ Infectious Diseases, Monash Health and School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.

PMID: 40966756
DOI: 10.1097/INF.0000000000004962

Long-term Impact of Invasive Meningococcal Disease in Australian Adolescents and Young Adults

Mark McMillan et al. Pediatr Infect Dis J. 2025.

. 2025 Sep 12.

doi: 10.1097/INF.0000000000004962. Online ahead of print.

Authors

Affiliations

¹ From the Vaccinology and Immunology Research Trials Unit, Women's and Children's Health Network.
² Adelaide Medical School, Robinson Research Institute, The University of Adelaide, Adelaide, South Australia.
³ Department of Infection and Immunity, Monash Children's Hospital, Melbourne.
⁴ Department of Paediatrics, University of Melbourne, Parkville, Victoria.
⁵ CHERI, The Children's Hospital at Westmead, Westmead.
⁶ Psychological Sciences, Faculty of Health, Southern Cross University, Coffs Harbour, New South Wales.
⁷ Northern Adelaide Local Health Network, Adelaide, South Australia.
⁸ Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia.
⁹ School of Medicine, University of Western Australia.
¹⁰ Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia.
¹¹ University of Sydney, Camperdown, New South Wales.
¹² Infectious Disease Unit, Central Adelaide Local Health Network.
¹³ Department of Microbiology and Infectious Diseases, Flinders Medical Centre.
¹⁴ College of Medicine and Public Health, Flinders University, Adelaide.
¹⁵ South Australian Health and Medical Research Institute, Women's and Children's Hospital, North Adelaide.
¹⁶ Infectious Diseases, Clinical Immunology and Allergy Division, Medicine Lyell McEwin Hospital, Adelaide, South Australia.
¹⁷ Infectious Management Services, Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland.
¹⁸ Infectious Diseases, Monash Health and School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia.

PMID: 40966756
DOI: 10.1097/INF.0000000000004962

Abstract

Background: Limited data exist on the long-term impact of invasive meningococcal disease (IMD) contracted during adolescence and early adulthood. This study aimed to determine the long-term outcomes on neurocognitive, psychological and quality of life (QoL) outcomes in adolescents and young adults.

Methods: IMD survivors aged 15-25 years (2-10 years post-IMD hospitalization) and non-IMD age-matched control participants were recruited across mainland Australian states (2016-2023) and completed neurocognitive, psychological, QoL and physical assessments.

Results: A total of 41 IMD cases (93% serogroup B and 73% females) and 51 control participants (57% females) were enrolled in the study. There was no clinically significant difference in Full-Scale IQ between IMD cases (106, SD 11) and control participants [109, SD 14, adjusted difference -4, (95% confidence interval, -10 to 3), P = 0.2]. Mean QoL scores for IMD cases (0.80, SD 0.21) and control participants (0.90, SD 0.09) were similar [adjusted difference -0.06, (95% confidence interval, -0.13 to 0.02), P = 0.2]. Mathematical reasoning was poorer in cases than in controls (P = 0.02). IMD cases had significantly higher rates of psychological symptoms than controls (58% vs. 31%, P = 0.01), including posttraumatic stress disorder symptoms (10% vs. 0%, P = 0.03) and alcohol dependence (18% vs. 2%, P = 0.04). Physician-assessed physical sequelae were present in 15% of IMD survivors (50% severe).

Conclusions: While long-term outcomes for adolescents and young adult IMD survivors show no significant impact on intellectual functioning or overall QoL, they experienced substantial psychological and physical sequelae. The impact on mental health underscores the need for comprehensive postdischarge psychological follow-up and care for IMD survivors, in addition to care for physical sequelae.

Keywords: adolescent; invasive meningococcal disease; neurocognitive; quality of life.

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References

1. Wang B, Santoreneos R, Giles L, et al. Case fatality rates of invasive meningococcal disease by serogroup and age: a systematic review and meta-analysis. Vaccine. 2019;37:2768–2782.
1. Baker CJ. Prevention of meningococcal infection in the United States: current recommendations and future considerations. J Adolesc Health. 2016;59(2 Suppl):S29–S37.
1. Edmond K, Clark A, Korczak VS, et al. Global and regional risk of disabling sequelae from bacterial meningitis: a systematic review and meta-analysis. Lancet Infect Dis. 2010;10:317–328.
1. Voss SS, Nielsen J, Valentiner-Branth P. Risk of sequelae after invasive meningococcal disease. BMC Infect Dis. 2022;22:148.
1. Davis KL, Bell TJ, Miller JM, et al. Hospital costs, length of stay and mortality associated with childhood, adolescent and young adult meningococcal disease in the US. Appl Health Econ Health Policy. 2011;9:197–207.

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Long-term Impact of Invasive Meningococcal Disease in Australian Adolescents and Young Adults

Affiliations

Long-term Impact of Invasive Meningococcal Disease in Australian Adolescents and Young Adults

Authors

Affiliations

Abstract

References

LinkOut - more resources

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