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Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease) Acknowledgements The Bacterial Meningitis Subcommittee of the Scientific Advisory Committee of HPSC wish to thank the following groups for sharing their work and experience in relation to research, policy, and guidance: • Royal College of Physicians of Ireland o The Faculty of Paediatrics o The Faculty of Public Health Medicine o The Faculty of Occupational Medicine o National Immunisation Advisory Committee, RCPI • Our Lady’s Children’s Hospital, Crumlin, Dublin • Children’s University Hospital, Temple Street, Dublin • The Irish Meningococcal and Meningitis Reference Laboratory, Children‘s University Hospital, Temple Street, Dublin • The National Pneumococcal Pilot Typing Project at the Department of Clinical Microbiology, RCSI Education and Research Centre, Beaumont Hospital, Dublin and the Children’s University Hospital, Temple Street, Dublin • The Irish Society of Clinical Microbiologists • HSE Departments of Public Health • The Irish College of General Practitioners • Infection Prevention Society (Ireland) (formerly the Infection Control Nurses Association) • Infectious Diseases Society of Ireland • Intensive Care Society of Ireland • Department of Health • Meningitis Research Foundation • Meningitis Trust Guidelines, Policies and Standard Operating Procedures Reviewed In developing the guidance the subcommittee reviewed existing guidelines that were in use both nationally and internationally. The Subcommittee would like to acknowledge in particular the information provided in guidance documents on bacterial meningitis from the UK (HPA), Scotland, Australia, the US (CDC, AAP, APLS,) and ECDC as well as HSE Departments of Public Health and hospitals, including; • Guidance for the early clinical and public health management of meningococcal disease in Australia. Australian Government Department of Health and Ageing, October 2007 1 • Public health management of sporadic cases of invasive meningococcal disease and their contacts. Stockholm: ECDC; 2010 2 • Guidance for public health management of meningococcal disease in the UK. Health Protection Agency Meningococcus Forum. Updated 2011 3 • HPA interim guidance for the public health management of clusters of serious pneumococcal disease in closed settings (2008) 4 Additional sources of information included; • Meningitis Research Foundation (UK) and British Infection Society - documents • Scottish Intercollegiate Guidelines Network (SIGN) - “Management of invasive meningococcal disease in children and young people” 5 • National Institute for Health and Clinical Excellence - “Bacterial meningitis and meningococcal septicaemia in children”( 2010) 6 -8-
Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease) Terms of Reference 1. To review the guidance on the prevention and control of bacterial meningitis and invasive meningococcal disease in Ireland including: • Management to reduce mortality and morbidity, during the pre-admission and continuing care phases • Investigation of suspected cases • Case definitions • Public health action after a single case • Management of clusters. 2. To review the epidemiology of bacterial meningitis and invasive meningococcal disease and to provide advice as required to the RCPI National Immunisation Advisory Committee on the use of vaccines to prevent cases of meningitis/encephalitis. 3. To act as a source of expert advice on meningitis and invasive meningococcal disease when required. 4. To co-ordinate with the Vectorborne Sub-Committee of the Scientific Advisory Committee of the Health Protection Surveillance Centre to ensure consistency of guidance especially in relation to arboviral disease. (Specific guidance in relation to the surveillance and control of viral meningitis and encephalitis is being developed separately). -9-
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