NEW YORK (Reuters Health) - Among infants who survive a bout of bacterial meningitis, many exhibit no apparent disability at 5 years of age, British investigators report, but about one quarter fail to pass standardized testing at age 16.

"It is essential that all cases of bacterial meningitis occurring during the first year of life are followed up fully so that children who require educational and other support are recognized at an early age," Dr. John de Louvois and his associates advise in their paper published online in the Archives of Disease in Childhood.

Dr. de Louvois and his team at Imperial College School of Medicine in London had initiated a national incidence study in 1985 to 1987, with the goal of identifying all infants with bacterial meningitis in England and Wales during that time-frame. When the children reached 5 years of age, the researchers documented meningitis-associated disability in 16.5% of cases, who thus required special educational needs.

"Local education authorities are required by law to make special educational provision for such children," Dr. de Louvois and his associates note. However, only 7.8% of index cases were in special schools.

Their current study included 461 case subjects and 289 age- and gender-matched controls. Academic achievement was evaluated when participants were 16 years old.

Among the cases, 25.4% failed to attain a grade of at least a C on any of the five General Certificate of Secondary Education exams, versus 6.6% of the control subjects (p < 0.0001, odds ratio (OR) = 4.8).

Among the cases who had exhibited no signs of meningitis-associated disability at age 5 and were attending comprehensive schools, nearly half failed to meet the national standard, the investigators add.

"It is alarming that children who appeared to have escaped meningitis unscathed when assessed at age 5 did no better in their GCSE examinations than those with recognized disabilities," Dr. de Louvois and his associates write.

They emphasize that children who contract bacterial meningitis before 12 months of age require a full post-infection medical assessment along with continuing education support throughout their academic years.