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

Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease)
Background to the guidelines
Introduction
Bacterial meningitis or septicaemia is a serious condition with high morbidity and significant mortality. Individuals
with this disease can present in the community and deteriorate rapidly prior to admission to hospital. Early
recognition, treatment and referral to hospital improves patient outcome. Despite the introduction of routine
immunisation to prevent meningococcal C disease and the subsequent decline in disease incidence, there continues
to be an important role for rapid and targeted public health control measures to prevent the spread of disease.
These guidelines update previous guidance issued by the Department of Health and Children (DoH) in 1999
(Guidance on the Management of Meningococcal disease - Working Group Report on Bacterial Meningitis and
Related Conditions 1999).
Purpose and Scope
The purpose of these guidelines is to provide comprehensive guidance on the early clinical and public health
management of bacterial meningitis (including meningococcal disease, Haemophilus influenzae type b disease and
clusters of serious pneumococcal disease).
The guidelines address sporadic cases, clusters of cases occurring in the community, chemoprophylaxis, vaccination
and communications.
These guidelines are intended to
• Promote best practice
• Standardise practice and service delivery
• Ensure that legislative requirements are met
• Ensure that clinicians are clear on their roles and responsibilities
• Facilitate effective staff induction
• Act as an educational tool
• Act as a basis for audit and evaluation.
The guidelines are necessarily general and those using the guidelines are advised to seek expert advice on the
management of cases (from clinical microbiologists, infectious disease physicians, infection control, public health
physicians, and occupational health physicians) as required.
The guidance can be adapted depending on local circumstances and risk assessment of each suspected case or
situation.
Setting: Any community or clinical setting where a patient presents with the signs and symptoms of an acute
systemic febrile illness for which the clinician suspects a diagnosis of bacterial meningitis or septicaemia, for
example in primary care, hospital or other setting.
Population: These guidelines apply to all patients in whom bacterial meningitis or septicaemia is suspected and
their close contacts; adults and children; institutions or settings where cases occur.
Time: For patient: during pre-admission, in Emergency department of hospital, and while hospitalised. For the
family, close contacts, community following diagnosis of suspect bacterial meningitis.
Content
The guidelines cover the following aspects of management:
Pre-admission management, hospital management, surveillance, laboratory diagnosis, public health management
of sporadic cases of meningococcal disease, chemoprophylaxis, infection control. Although the focus is mainly on
meningococcal disease the management of H. influenzae type b and clusters of serious pneumococcal disease is also
considered.
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