Epidemiology and Infection

Day-care and meningococcal disease in young children

T.  GREIN  a1 c1 and D.  O’FLANAGAN  a2
a1 European Programme for Intervention Epidemiology Training (EPIET), 12, rue du Val d’Osne, F-94415 Saint Maurice, France
a2 National Disease Surveillance Centre, Dublin, Ireland


The Republic of Ireland has the highest incidence of meningococcal disease in Europe with 40% of all cases occurring in children under the age of 5 years. Attending day-care increases the risk of certain infections, including Haemophilus influenzae type b (Hib) meningitis. The risk of meningococcal disease associated with day-care is not known. We conducted a case-control study among pre-school children with 130 laboratory-confirmed cases and 390 controls, matched on age, gender and place of residence, to determine if day-care attendance was a risk factor for meningococcal disease. Multivariate analysis showed that day-care attenders had a lower risk of disease than non-attenders (OR 0·3, 95% CI 0·1–0·7) whereas the number of adults in a household, and household crowding were independent risk factors for disease. Asymptomatic carriers of Neisseria meningitidis are the main source of transmission and these carriers are usually adults. Regular day-care attendance may reduce this risk by removing children from close and prolonged contact with adults.

(Accepted June 1 2001)

c1 Author for correspondence.