Abstract

In the Federal Republic of Germany, four types of meningitis must be reported since 1980 instead of the previous two categories (i.e. meningococcal disease and other forms of meningitis). Consequently, various forms of purulent meningitis can be differentiated from viral meningitis. A retrospective study, considering the population of West Berlin, carried out between the years 1981 and 1985, shows the influence of age, nationality and living areas on morbidity and mortality rate. A critical evaluation was undertaken, considering possible changes in management efficiency of public health authorities since the introduction of the new reporting system. Population at high risk, predisposed to develop meningococcal meningitis, are mainly Turkish children living in areas of high population density and poor social structure. The activities of the public health administration seem inadequate. The reported meningitis cases were partly filed wrongly and thus were transmitted wrongly to the Federal Office of Statistics (Statistisches Bundesamt). No substantial scientific epidemiological analysis was performed. The most frequent reaction of public health authorities was disinfection of apartments, day-care centres and schools, as done for example in 67% of the reported meningococcal meningitis cases, although it is well known that there is no reason for room disinfection in droplet-transmitted infection of the nasopharyngeal mucosa. As shown by our results, the differentiation of the reporting system in use since 1980 did not prove advantageous considering the health policy and epidemiological research of prevention in our study area. Disinfection measures are obsolete.