{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:48:51Z","timestamp":1791568131680,"version":"4.3.4"},"reference-count":17,"publisher":"BMJ","issue":"6966","license":[{"start":{"date-parts":[[1994,11,26]],"date-time":"1994-11-26T00:00:00Z","timestamp":785808000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1994,10,11]]},"published-print":{"date-parts":[[1994,11,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    : To describe the epidemiology of primary bacterial meningitis in the North East Thames region over a three year period before and during the introduction of the vaccine for Haemophilus influenzae type b.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    : Analysis of information on cases of primary bacterial meningitis identified by microbiology laboratories in the region, with collection of case data by questionnaire.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures<\/jats:bold>\n                    : Annual incidence rates for types of meningitis according to age and ethnic group.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    : The annual incidence rates for the three major causes of bacterial meningitis in the general population were 1.9\/100000 for Neisseria meningitidis, 1.6\/100000 for Haemophilus influenzae before vaccination, and 1.0\/100000 for Streptococcus pneumoniae. Higher rates of H influenzae meningitis were found in Asians compared with white people (3.6\/100000 v 1.5\/100000, P = 0.01). As a result of the vaccine programme introduced in October 1992 the number of cases of H influenzae meningitis in children under 5 years has fallen by 87%.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    : Bacterial meningitis is a serious problem especially in preschool children. There are differences in the incidence of some causes of bacterial meningitis in different ethnic groups; with H influenzae type b being significantly more common among black and Asian people than among white people. The immunisation programme for H influenzae type b in the North East Thames region has been successful in reducing the incidence of this type of meningitis in Asian and white populations. The numbers were too small to evaluate in the black population.\n                  <\/jats:p>","DOI":"10.1136\/bmj.309.6966.1412","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:31:39Z","timestamp":1319743899000},"page":"1412-1414","source":"Crossref","is-referenced-by-count":26,"title":["Prospective study of bacterial meningitis in North East Thames region, 1991-3, during introduction of Haemophilus influenzae vaccine"],"prefix":"10.1136","volume":"309","author":[{"given":"Gillian","family":"Urwin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei F","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger A","family":"Feldman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1994,11,26]]},"reference":[{"key":"2025122312261258000_309.6966.1412.1","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1093\/infdis\/162.6.1316","article-title":"Bacterial meningitis in the United States, 1986: report of a multistate surveillance study.","volume":"162","author":"Wenger","year":"1990","journal-title":"J Infect Dis"},{"key":"2025122312261258000_309.6966.1412.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1985.03350360075022"},{"key":"2025122312261258000_309.6966.1412.3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500020055031"},{"key":"2025122312261258000_309.6966.1412.4","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92117-X"},{"key":"2025122312261258000_309.6966.1412.5","first-page":"R13","article-title":"Haemophilus influenzae: the efficacy of reporting invasive disease in England and Wales.","volume":"2","author":"MacLeod","year":"1994","journal-title":"Commun Dis Rep CDR Rev"},{"key":"2025122312261258000_309.6966.1412.6","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1016\/S0140-6736(86)90124-8","article-title":"An outbreak of meningococcal disease in Gloucestershire.","volume":"ii","author":"Cartwright","year":"1986","journal-title":"Lancet"},{"key":"2025122312261258000_309.6966.1412.7","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1136\/bmj.303.6800.441","article-title":"Epidemiology of Haemophilus influenzae type b invasive disease in Wales.","volume":"303","author":"Howard","year":"1991","journal-title":"BMJ"},{"key":"2025122312261258000_309.6966.1412.8","first-page":"R76","article-title":"Meningococcal infections in England and Wales: report of the meningococcal reference laboratory for 1990.","volume":"1","author":"Jones","year":"1991","journal-title":"Commun Dis Rep CDR Rev"},{"key":"2025122312261258000_309.6966.1412.9","doi-asserted-by":"publisher","DOI":"10.1136\/adc.64.4.517"},{"key":"2025122312261258000_309.6966.1412.10","first-page":"21","article-title":"Laboratory based surveillance for meningococcal disease in selected areas, United States, 1989\u201391.","volume":"42","author":"Jackson","year":"1993","journal-title":"MMWR"},{"key":"2025122312261258000_309.6966.1412.11","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1136\/bmj.303.6811.1203-b","article-title":"Haemophilus influenzae type b invasive disease (letter).","volume":"303","author":"Fallon","year":"1991","journal-title":"BMJ"},{"key":"2025122312261258000_309.6966.1412.12","first-page":"385","article-title":"The epidemiology of Haemophilus influenzae invasive disease in Scotland prior to immunisation.","volume":"56","author":"Brewster","year":"1993","journal-title":"Health Bull (Edinb)"},{"key":"2025122312261258000_309.6966.1412.13","first-page":"13","article-title":"A survey of invasive Haemophilus influenzae infections.","volume":"2","author":"Nazareth","year":"1992","journal-title":"Commun Dis Rep CDR Rev"},{"key":"2025122312261258000_309.6966.1412.14","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1136\/bmj.309.6950.287","article-title":"Public health and the 1991 census: non random underenumeration complicates interpretation.","volume":"309","author":"Raleigh","year":"1994","journal-title":"BMJ"},{"key":"2025122312261258000_309.6966.1412.15","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/153.1.17"},{"key":"2025122312261258000_309.6966.1412.16","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1136\/pgmj.66.782.989","article-title":"Ethnicity and the use of health services.","volume":"66","author":"Gillam","year":"1990","journal-title":"Postgrad Med J"},{"key":"2025122312261258000_309.6966.1412.17","first-page":"R17","article-title":"Hib immunisation catch up program in north east Thames.","volume":"2","author":"O'Brien","year":"1994","journal-title":"Com Dis Rep CDR Rev"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.309.6966.1412","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.309.6966.1412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T20:26:20Z","timestamp":1766521580000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.309.6966.1412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,11,26]]},"references-count":17,"journal-issue":{"issue":"6966","published-online":{"date-parts":[[1994,11,26]]},"published-print":{"date-parts":[[1994,11,26]]}},"alternative-id":["10.1136\/bmj.309.6966.1412"],"URL":"https:\/\/doi.org\/10.1136\/bmj.309.6966.1412","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1994,11,26]]}}}