Guidelines for the Early Clinical and Public Health Management of ...

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Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease) Document Control Title Guidelines for the early clinical and public health management of bacterial meningitis (including meningococcal disease) Document Purpose To promote best practice management of bacterial meningitis (and meningococcal disease) in primary care and at hospital level To standardise practice To ensure that GPs, hospital and public health clinicians are clear on roles and responsibilities To act as an educational tool To act as a basis for audit and evaluation Target Audience Health care staff dealing with patients where a diagnosis of bacterial meningitis or septicaemia is suspected Revision Number 2 Document Approved by Document Developed by Responsibility for Review and Audit Scientific Advisory Committee, Health Protection Surveillance Centre Bacterial Meningitis Sub-Committee of the Scientific Advisory Committee, HPSC Hospitals, Departments of Public Health, HPSC Approval Date January 2012 Revision Date 2015 Contact Person Dr Suzanne Cotter Health Protection Surveillance Centre Email: suzanne.cotter@hse.ie Web: www.hpsc.ie -2-
Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease) Contents Background to the guidelines.............................................................................................................................. 4 Members of the Working Group............................................................................................................................7 Acknowledgements............................................................................................................................................ 8 Terms of Reference.............................................................................................................................................. 9 Foreword............................................................................................................................................................10 Key Recommendations.......................................................................................................................................11 Glossary of Acronyms.........................................................................................................................................15 Chapter 1. Introduction.......................................................................................................................................16 Chapter 2. Pre-admission Management............................................................................................................. 17 Chapter 3: Hospital Management..................................................................................................................... 20 Chapter 4: Surveillance..................................................................................................................................... 36 Chapter 5. Epidemiology of Meningococcal Disease and other Forms of Bacterial Meningitis (Ireland).............41 Chapter 6. Laboratory Diagnosis of Invasive Meningococcal Disease................................................................ 52 Chapter 7. Public Health Management of Sporadic Cases of Meningococcal Disease........................................ 57 Chapter 8. Management of Clusters/ Outbreaks of Meningococcal Disease...................................................... 67 Chapter 9. Chemoprophylaxis for Contacts of Meningococcal Disease...............................................................73 Chapter 10. Infection Control for Meningococcal Disease...................................................................................77 Chapter 11. Public Health Management of Cases of H. influenza Type b (Hib) Disease....................................... 79 Chapter 12. Public Health Management of Clusters of Serious Pneumococcal Disease......................................81 Appendix 1........................................................................................................................................................ 86 Annual Number of Bacterial Meningitis Notifications by Causative Pathogen, 1999-2010.........................................86 Appendix 2. Useful Resources........................................................................................................................... 87 Appendix 3. Enhanced Surveillance Forms........................................................................................................ 88 Invasive meningococcal disease (Sample).....................................................................................................................89 Invasive pneumococcal disease (Sample)......................................................................................................................90 Invasive Haemophilus influenzae (Sample)................................................................................................................... 92 Contacts’ recording form (Sample)................................................................................................................................ 93 IPD cluster investigation form (Sample)........................................................................................................................94 Appendix 4 – Examples of Chemoprophylaxis Information............................................................................... 95 Rifampicin – Adult..........................................................................................................................................................96 Rifampicin – Child..........................................................................................................................................................98 Ceftriaxone......................................................................................................................................................................99 Ciprofloxacin................................................................................................................................................................. 100 Appendix 5 – Examples of Vaccination Information......................................................................................... 101 MenC- immunisation against meningococcal disease - group C.................................................................................102 Meningococcal vaccine – group A,C,W135,Y – conjugate vaccine................................................................................103 Vaccination administration record for patient............................................................................................................. 104 Appendix 6. Examples of Templates for Letters................................................................................................105 GP whose Patients were Close Contacts and Given Chemoprophylaxis..................................................................... 106 Letter to GP re Rifampicin and Warfarin /Anticonvulsants..........................................................................................107 Letter to GP listing patients who have received meningococcal vaccine.................................................................... 108 Letter informing GP of a case of meningococcal disease in the locality..................................................................... 109 Letter to parents informing them of case of meningococcal disease in their child’s school........................................ 110 Letter informing student of meningococcal case in his/her college............................................................................. 111 Workplace letter.............................................................................................................................................................112 Appendix 7. Examples of Disease Information Leaflets......................................................................................113 Meningococcal disease – meningitis or septicaemia.................................................................................................... 114 Invasive pneumococcal disease – meningitis or septicaemia...................................................................................... 116 Haemophilus influenzae type b disease.........................................................................................................................117 Viral meningitis.............................................................................................................................................................. 118 Refererences.....................................................................................................................................................119 -3-
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