Minerva

The decline in meningitis and other stories . . .

BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.h7011 (Published 06 January 2016) Cite this as: BMJ 2016;352:h7011

Declining meningitis

Adult bacterial meningitis is becoming rarer. In the Netherlands, the incidence in people over 16 years dropped from 1.72 cases/100 000/year in 2007-08 to 0.94/100 000/year in 2013-14 (Lancet Infect Dis 2015, doi:10.1016/S1473-3099(15)00430-2). Streptococcus pneumoniae caused 72% of infections. This drop coincided with the introduction of pneumococcal conjugate vaccination for children, making herd immunity a likely factor. At the same time adjunctive dexamethasone, which was associated with better outcomes, was more widely used.

Shared ignorance on sharing

The new year will see major initiatives to promote shared decision making between patients and clinicians. But despite the extensive literature on the subject, a new systematic review found few randomised controlled trials in the field with measures of participation in decision making and at least one health outcome (Med …

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