Abstract Details

Title Neurological Infections in Universal Health Care: Epidemiology, Incidence, and Outcomes

Topic Infectious Disease

Presentation(s) S28 - Infectious Disease: Chronic Meningitis and the Immunosuppressed (1:00 PM-1:12 PM)

Poster/Presentation
Number 001

Background Neurological infections cause substantial morbidity and mortality. Despite the impact on patients’ health and the health care delivery system, the incidence and outcomes of neurological infections are poorly understood.

Objective To investigate the epidemiological, demographic and clinical features of encephalitis and bacterial meningitis in the province of Alberta, Canada from 2004 to 2018.

Design/Methods A population-based study was performed of all patients receiving health care in Alberta (population: 4.4 million) with ICD-10 codes corresponding to encephalitis and bacterial meningitis (BM) over the past 14 years derived from hospital admission and discharge records. Data were cross validated for identified diagnoses based on microbial or autoimmune aetiologies in datasets from the Alberta Provincial Laboratory.

Results All cases of potential neurological infection (n=4651) were screened from which encephalitis cases (n=2035) were identified including laboratory-confirmed viral aetiologies (n=833) and without associated aetiologies (n=1329). Laboratory-confirmed BM cases (n=1405) identified in the same study period. Yearly incidences ranged for BM (0.6 to 2.6%) and encephalitis (0.49 to 2.77%). Of all screened neurological infection cases, 27.2% were children (<18yr), and 72.7% were adults with similar rates in both sexes. Among children, most BM cases occurred before the age of 2 years whereas encephalitis cases spanned the first 12 years of life, peaking at 5 years. In adults, encephalitis predominated between ages 30 to 65 years while BM was diagnosed principally between 40 and 60 years. Morbidity, assessed by the Charlson score, revealed encephalitis cases had scores ranging from 0 to 5 while BM cases displayed scores of 2 or less. Cancer as a comorbidity (n=224) was a major risk factor for neurological infections (encephalitis, n=163; BM, n=67).

Conclusions

Neurological infections occur frequently in the setting of universal health care. While encephalitis etiology is often not established, it is associated with greater comorbidity rates.

Authors/Disclosures
Wasan Abd Wahab, MBBS PRESENTER	No disclosure on file
Jeffrey Bakal	Jeffrey Bakal has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association.
	No disclosure on file
Christopher Power, MD	Dr. Power has nothing to disclose.

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