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Journal of Public Health Advance Access published online on November 25, 2004
Journal of Public Health, doi:10.1093/pubmed/fdh188
Copyright © 2004 by the Faculty of Public Health of the Royal Colleges of Physicians of the United Kingdom.
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Article

Incidence of meningitis and of death from all causes among users of cochlear implants in the United Kingdom

A. Q. Summerfield PhD1*, S. E. Cirstea PhD1, K. L. Roberts BA1, G. R. Barton MSc1, J. M. Graham FRCS2, and G. M. O’Donoghue FRCS3

1 MRC Institute of Hearing Research, University Park, Nottingham NG7 2RD
2 Royal National Throat Nose and Ear Hospital, 330 GrayÆs Inn Road, London WC1X 8DA
3 Department of Otolaryngology, University Hospital, Nottingham NG7 2UH

* To whom correspondence should be addressed.
A. Q. Summerfield, E-mail: aqs1{at}york.ac.uk


  Abstract

Background During 2002, there was an increase in reports of bacterial meningitis among people with cochlear implants in Europe and North America. One model ofimplant, which included a space-occupying ‘positioner’, was recalled. Implantation of a positioner was shown to be a risk factor for meningitis among children in the United States. The situation in the United Kingdom was not known.

Methods We ascertained the cohort of people who had received cochlear implants with intra-cochlear electrodes in UK hospitals prior to 1 October 2002 and were permanently resident in the United Kingdom. We compared the incidence of meningitis, and the causes and incidence of death from all causes, between the cohort and reference populations.

Results Of 1851 children (66 with positioners), none had contracted meningitis. Neither the incidence rate of meningitis, nor the cumulative mortality from all causes, differed significantly between implanted children and values expected for the general population. Of 1779 adults (139 with positioners), five had contracted meningitis with three fatalities. No case of meningitis involved a positioner and four of the cases, including the fatalities, possessed risk factors unrelated to implantation. Although the incidence rate of meningitis was significantly higher in implanted adults than the general population, cumulative mortality from all causes was never higher, and was significantly lower at some time points after implantation.

Conclusion Specific evidence of the association between bacterial meningitis and implantation with a positioner that arose in the United States and mainland Europe during 2002 has not been found in the United Kingdom.

Keywords: meningitis, cochlear implantation, mortality, hearing loss.
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