Meningococcal Meningitis and Coal Mining in Provincial England: Geographical Perspectives on a Major Epidemic, 1929–33.

This article presents the first systematic study of the spatial transmission of the 1929–33 epidemic of meningococcal meningitis and its association with local coal mining communities in three adjacent high incidence counties of England; Nottinghamshire, Derbyshire, and the West Riding of Yorkshire. Drawing on a robust method of spatial epidemiological analysis (swash‐backwash model), we demonstrate a gradient response with local levels of employment in coal mining for each of three key parameters of the epidemic wave: spatial velocity of transmission; duration of infectivity; and spatial reach. Partial least squares regression analysis identifies the relatively young and fertile demographic of local mining communities as the principal determinant of the resulting epidemic burden. Other sociodemographic parameters, including established risk factors for invasive meningococcal disease (low social class, high residential density, and overcrowding) are found to play little, or no, role in the spatial distribution of the disease. Our findings have importance for understanding the historic links between the coal mining industry and epidemic meningococcal meningitis, and point to possible present‐day opportunities for intervention through the designation of coal mining communities as defined risk groups for meningococcal vaccines. [ABSTRACT FROM AUTHOR]