Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study
BackgroundMeningitis and meningoencephalitis (MME) are potential medical emergencies. Mandatory reporting of all MME cases in the Israel Defense Force (IDF) allows accurate characterization of MME incidence and course. In the present study, we described the epidemiology of MME in soldiers.MethodsMed...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-06-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.887677/full |
| _version_ | 1818242553760186368 |
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| author | Shany Guly Gofrit Yoav Yechezkel Pikkel Yoav Yechezkel Pikkel Hagai Levine Shifra Fraifeld Shifra Fraifeld Shlomzion Kahana Merhavi Limor Friedensohn Limor Friedensohn Ruth Eliahou Tamir Ben-Hur Asaf Honig Asaf Honig |
| author_facet | Shany Guly Gofrit Yoav Yechezkel Pikkel Yoav Yechezkel Pikkel Hagai Levine Shifra Fraifeld Shifra Fraifeld Shlomzion Kahana Merhavi Limor Friedensohn Limor Friedensohn Ruth Eliahou Tamir Ben-Hur Asaf Honig Asaf Honig |
| author_sort | Shany Guly Gofrit |
| collection | DOAJ |
| description | BackgroundMeningitis and meningoencephalitis (MME) are potential medical emergencies. Mandatory reporting of all MME cases in the Israel Defense Force (IDF) allows accurate characterization of MME incidence and course. In the present study, we described the epidemiology of MME in soldiers.MethodsMedical charts of 860,000 combat and non-combat soldiers serving during the years 2004–2015, accounting for 2,256,060 patient years, were retrospectively evaluated. The diagnosis of MME was based on signs of meningeal irritation and a count of > 5 white blood cells (WBC) in the cerebrospinal fluid (CSF). Data on the diagnosis of bacterial or aseptic MME, significant sequelae, and associated mortality were collected.ResultsApproximately 273 cases of MME were diagnosed. Overall, MME incidence was 12.1/100,000 patient-years. Bacterial and viral pathogens were identified in 31/273 (11.4%) and 52/273 (19%) cases, respectively. Combat soldiers had higher incidence of bacterial meningitis [14/40 (35%) vs. 31/212 (14.6%); p = 0.002] and meningoencephalitis [13/40 (32.5%) vs. 33/212 (15.6%); p = 0.023] compared to non-combat soldiers. Their clinical presentation was more severe, including confusion [10/40 (25%) vs. 22/212 (10.4%); p = 0.018], focal neurological deficits [12/40 (30%) vs. 11/212 (5.2%); p < 0.0001], and status epilepticus [3/40 (7.5%) vs. 0/212 (0.0%); p < 0.01]. Mortality among combat soldiers was higher [5/40 (15%) vs. 1/212 (0.5%); p < 0.001]. N. meningitidis was the most frequently isolated bacteria, despite universal preventative vaccination.ConclusionThe incidence of bacterial MME in the IDF is higher than in the civilian population. Combat soldiers present with higher incidence of meningoencephalitis and bacterial meningitis. |
| first_indexed | 2024-12-12T13:47:04Z |
| format | Article |
| id | doaj.art-c600f5c8faad42fdb97244132b686b0d |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-12T13:47:04Z |
| publishDate | 2022-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-c600f5c8faad42fdb97244132b686b0d2022-12-22T00:22:40ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-06-011310.3389/fneur.2022.887677887677Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based StudyShany Guly Gofrit0Yoav Yechezkel Pikkel1Yoav Yechezkel Pikkel2Hagai Levine3Shifra Fraifeld4Shifra Fraifeld5Shlomzion Kahana Merhavi6Limor Friedensohn7Limor Friedensohn8Ruth Eliahou9Tamir Ben-Hur10Asaf Honig11Asaf Honig12Medical Corps of the Israel Defense Forces, Haifa, IsraelMedical Corps of the Israel Defense Forces, Haifa, IsraelDepartment of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, IsraelBraun School of Public Health and Community Medicine, Hebrew University-Hadassah Medical School, Jerusalem, IsraelDepartment of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, IsraelDepartment of Radiology, Hadassah Medical Center, Hebrew University, Jerusalem, IsraelDepartment of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, IsraelMedical Corps of the Israel Defense Forces, Haifa, IsraelDivision of Endocrinology, Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, IsraelDepartment of Radiology, Hadassah Medical Center, Hebrew University, Jerusalem, IsraelDepartment of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, IsraelMedical Corps of the Israel Defense Forces, Haifa, IsraelDepartment of Neurology, Hadassah Medical Center, Hebrew University, Jerusalem, IsraelBackgroundMeningitis and meningoencephalitis (MME) are potential medical emergencies. Mandatory reporting of all MME cases in the Israel Defense Force (IDF) allows accurate characterization of MME incidence and course. In the present study, we described the epidemiology of MME in soldiers.MethodsMedical charts of 860,000 combat and non-combat soldiers serving during the years 2004–2015, accounting for 2,256,060 patient years, were retrospectively evaluated. The diagnosis of MME was based on signs of meningeal irritation and a count of > 5 white blood cells (WBC) in the cerebrospinal fluid (CSF). Data on the diagnosis of bacterial or aseptic MME, significant sequelae, and associated mortality were collected.ResultsApproximately 273 cases of MME were diagnosed. Overall, MME incidence was 12.1/100,000 patient-years. Bacterial and viral pathogens were identified in 31/273 (11.4%) and 52/273 (19%) cases, respectively. Combat soldiers had higher incidence of bacterial meningitis [14/40 (35%) vs. 31/212 (14.6%); p = 0.002] and meningoencephalitis [13/40 (32.5%) vs. 33/212 (15.6%); p = 0.023] compared to non-combat soldiers. Their clinical presentation was more severe, including confusion [10/40 (25%) vs. 22/212 (10.4%); p = 0.018], focal neurological deficits [12/40 (30%) vs. 11/212 (5.2%); p < 0.0001], and status epilepticus [3/40 (7.5%) vs. 0/212 (0.0%); p < 0.01]. Mortality among combat soldiers was higher [5/40 (15%) vs. 1/212 (0.5%); p < 0.001]. N. meningitidis was the most frequently isolated bacteria, despite universal preventative vaccination.ConclusionThe incidence of bacterial MME in the IDF is higher than in the civilian population. Combat soldiers present with higher incidence of meningoencephalitis and bacterial meningitis.https://www.frontiersin.org/articles/10.3389/fneur.2022.887677/fullmeningitismeningoencephalitismeningitis epidemiologymilitary medicineyoung adults |
| spellingShingle | Shany Guly Gofrit Yoav Yechezkel Pikkel Yoav Yechezkel Pikkel Hagai Levine Shifra Fraifeld Shifra Fraifeld Shlomzion Kahana Merhavi Limor Friedensohn Limor Friedensohn Ruth Eliahou Tamir Ben-Hur Asaf Honig Asaf Honig Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study Frontiers in Neurology meningitis meningoencephalitis meningitis epidemiology military medicine young adults |
| title | Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study |
| title_full | Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study |
| title_fullStr | Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study |
| title_full_unstemmed | Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study |
| title_short | Characterization of Meningitis and Meningoencephalitis in the Israeli Defense Forces From 2004 to 2015: A Population-Based Study |
| title_sort | characterization of meningitis and meningoencephalitis in the israeli defense forces from 2004 to 2015 a population based study |
| topic | meningitis meningoencephalitis meningitis epidemiology military medicine young adults |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.887677/full |
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