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)
Table 10.1 Infection control precautions recommended for meningococcal cases in clinical settings
Requirement
Gloves
Impermeable apron/gown
Mask
Goggles/face-shield
Patient in single room
Negative pressure
Transport of patients
Other
Infection control team informed
Additional precautions for the first 24 hours of
appropriate systemic antibiotic treatment
Standard precautions
Standard precautions
Surgical mask a
Protect face if splash likely†
Yes - door closed
Not required
Surgical mask a for patient
Notify area receiving patient
If single room unavailable provide a minimum
one metre of separation between patients in ward
accommodation
Standard precautions
a
Surgical mask refers to a fluid-repellent, paper filter mask used in surgical procedures.
†Wear a mask (shield type) when carrying out close examination on a patient (e.g. when performing ophthalmic
fundoscopy) especially if they have coughing, sneezing, or if undertaking aerosol generating procedure (including
examination of throat).
10.3 Visitors of case
Visitors within 1 metre of the case in the first 24 hours of antibiotic treatment should wear a surgical mask
(precautions for droplet transmission). Thereafter, standard infection control measures apply. Visitors do not need to
wear protective clothing unless they are at risk of exposure to naso-pharyngeal secretions but should be instructed
to decontaminate their hands before and after visiting cases.
10.4 Pathologists and anatomical pathology technicians
Pathologists and pathology technicians who may be exposed to infected airborne droplets during the performance of
an autopsy should receive chemoprophylaxis when a mask has not been worn and when the deceased individual did
not receive appropriate systemic antibiotics for a minimum of 24 hours prior to death.
10.5 Relatives contact with body of deceased
It is not necessary to restrict relatives viewing, touching, and kissing the body on infection control grounds. However,
chemoprophylaxis and vaccination may be required if these individuals were close contacts of the deceased prior to
death (see Section 7.2 on chemoprophylaxis).
10.6 Handling and transport of deceased patients
All bodies of deceased patients should be handled using standard precautions. Body bags are not necessary and
transport to other countries for burial or cremation does not pose a risk. There is no restriction on embalming.
10.7 Pre-exposure vaccination
Staff handling or conducting research on N. meningitidis or staff working in higher risk settings such as the IMMRL or
paediatric or infectious disease units where admissions related to meningococcal disease are frequent, may have a
higher level of exposure that would justify vaccination.
The need for, and timing of, a booster dose of a quadrivalent vaccine has not yet been determined.
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