1. Source: ECDC report 2011

2. Meningococcal Disease deadly, disabling, disfiguring Leading infectious cause of death in children Long-term after effects for 1 in 3 affected Top among illnesses feared by parents Strikes suddenly, mainly healthy children Rapid onset: brief window for effective medical treatment Staggering costs

3. After effects MeningitisSepticaemia Deafness Severe learning impairment Paralysis, plegia Blindness Epilepsy Psychosocial problems Amputations Skin, muscle damage Distorted bone growth Arthritis Kidney damage Cognitive problems Psychosocial problems

4. Costs of severe cases MeningitisSepticaemia Acute medical costs Long-term medical costs Specialist equipment Special education Direct social care costs, benefits, lost tax revenue Acute costs Outpatient costs, prosthetics, corrective surgery Specialist equipment School adaptation and support Direct social costs, benefits, lost tax revenue

5. Litigation costs

6. Limited potential for improved diagnosis and treatment Early symptoms resemble mild illnesses ~50% of children sent home by GPs Short window for intervention Most deaths within 24 hours Better antibiotics and management: fatality reduced 2 decades: every new therapeutic drug unsuccessful in clinical trials

7. Impact of Hib vaccine in Ireland Adapted from Guidelines for (HPSC (2012) The early clinical and public health management of bacterial meningitis

8. Incidence of Meningococcal Disease in Ireland Men C vaccine

9. Reduction in invasive pneumococcal disease in young children

12. Prevention is better than cure