This month many teenagers will be preparing for their forthcoming GCSE exams. This paper highlights the academic difficulties facing survivors of childhood meningitis when they sit their GCSEs.

The study included 461 teenagers who had bacterial meningitis in infancy, comparing them with 289 age- and sex-matched controls.

Index cases had been assessed for disability at the age of five, and 16.5 per cent had been diagnosed with severe or moderate disability.

The authors examined GCSE results as a proxy for academic achievement.

A quarter of index cases passed no exams. Index cases who attended comprehensive schools were twice as likely to sit fewer than five GCSEs compared with the control group and were also half as likely to achieve five grade 'C' or above passes compared with controls.

Interestingly, children in the index group who were not considered to have significant disability at age five were just as likely to do badly at GCSE level as those with recognised disabilities.

The causative organism was not considered when these statistics were examined. However, it was apparent that the age at which the child developed meningitis did not seem to matter, with no difference in academic performance reported between children who had neonatal meningitis and those who were aged over two months when they developed the condition.

Educational 'statements' are an important tool in limiting the effect of disability on academic achievement. However, in children who attended comprehensive schools and did not attempt any GCSEs, only 21 per cent of teenagers who had had meningitis as a child had been 'statemented', compared with 60 per cent of children in the control group.

The study did not consider the continuing social and psychological impacts, but, given the dramatic academic outcomes, one wonders about the effects in these fields.

From a GP perspective this paper highlights the need to ensure that community child health services remain engaged in order to optimise support for children who have had meningitis and their families. Next time I see 'meningitis' on the summary list for one of my patients I plan to check that follow-up is in place.

de Louvois J, Halket S, Harvey D. Effect of meningitis in infancy on school-leaving examination results Arch Dis Child 2007 doi: 10.1136/adc.2006.105916