BPSU study - Clinical characteristics of children with pneumococcal meningitis

BPSU surveillance of the clinical characteristics of children with pneumococcal meningitis is due to commence in January 2020. This study will estimate the incidence of childhood pneumococcal meningitis in the era of pneumococcal conjugate vaccines; describe symptoms and signs at presentation; describe the investigations, management and treatment in hospital; describe the clinical course of illness; and describe the outcomes of pneumococcal meningitis.

The lead investigator is the winner of the Sir Peter Tizard Research Bursary 2017-18.

Lead investigator

Dr Godwin Oligbu
Immunisation and Countermeasures Division
Public Health England
National Infection Service
61 Colindale Avenue
London NW9 5EQ
Email: godwin.oligbu@nhs.net

About the study

The pneumococcus (Streptococcus pneumoniae) is a major global cause of meningitis, which can lead to death, with up to a third of survivors developing life long complications, including deafness, blindness, epilepsy and cerebral palsy. There are almost 100 different strains (serotypes) of the pneumococcus that cause serious infections in humans.

The UK and Ireland introduced a vaccine against the seven most common serotypes (PCV7) in the national childhood immunisation programme in 2006 and 2008. This vaccine was then replaced with one that protected against 13 serotypes (PCV13) in 2010. Both vaccines have been very successful in preventing pneumococcal disease caused by the pneumococcal serotypes that are covered by the vaccine.

Now, nearly all pneumococcal infections are caused by pneumococcal serotypes that are not covered by the vaccine (non-vaccine serotypes). We know very little about these rare but very important non-vaccine pneumococcal serotypes. Our aim is to understand the virulence of the current pneumococcal serotypes causing meningitis to better understand their clinical presentation, disease progression, severity and outcomes.

Case definition

Confirmed cases: Children aged <16 years with CSF positive for pneumococcus by culture AND/OR PCR

Probable case: CSF pleocytosis (abnormal increase in number of white blood cells in the CSF) AND pneumococcus identified in a sterile site other than the CSF, i.e. blood, urine, synovial fluid, pleural space, deep intraoperatively accessed tissue, pus

Possible cases: No CSF specimen but abnormal temperature control (>38oC or <36oC) AND pneumococcus identified in sterile site other than CSF (blood, urine, synovial fluid, pleural space, deep intraoperatively accessed tissue or pus) AND clinical features indicative of meningitis (any combination of headache, stiff neck, vomiting, photophobia, confusion/delirium, unconscious, coma, seizures, bulging fontanelle, signs of meningism on examination)

Reporting instructions

Please report any child seen in the last month who meets the case definition in the UK or the Republic of Ireland regardless of country of birth.


January 2020 to January 2022 (25-months of surveillance). Follow-up until January 2023 (1-year follow-up).


This study is funded by the Sir Peter Tizard Research Bursary and through a grant from Action Medical Research.


The study has been approved by London-Dulwich Research Ethics Committee (reference: 19/LO/0978); HRA Confidentiality Advisory Group (reference: 19/CAG/0073); and Public Benefit and Privacy Panel for Health and Social Care (reference: 1819-0357).

Privacy notice

Public Health England (PHE) is the sponsor and data controller for this research study. The Head of Governance at PHE can be contacted at elizabeth.coates@phe.gov.uk.

The study team at PHE will use information from medical records for a medical research study. The lawful basis for collecting and using personal information in this study is article 6(1)(e) and article 9(2)(j) of the GDPR which allows us to process personal data when it is for scientific research in the public interest. We will collect information about children with a new diagnosis of pneumococcal meningitis from the doctors who are looking after them. Doctors will not provide identifying information like names and addresses, but they will provide personal information like sex, ethnic group and date of birth. The smallest amount of personal information will be used. We cannot withdraw or remove information from the study but personal information will be deleted or de-personalised when the study finishes. PHE will securely store this information for 20 years. 

If you want access to the information in your child’s NHS records, then you should contact your child’s NHS hospital/doctor. 

If you want to find out more about how personal information is used in the study, please contact godwin.oligbu@nhs.net.

If you wish to complain about the use of your personal information, then you should contact the Information Commissioner’s Office:

Information Commissioner’s Office
Wycliffe House
Water Lane
Cheshire SK9 5AF

Helpline number: 0303 123 1113
Email: casework@ico.org.uk

Support groups


Logos - BPSU, Public Health England, St George's University of London