New knowledge from the UK Well being Safety Company (UKHSA) exhibits a vital rise in instances of invasive meningococcal illness (IMD) throughout England throughout 2022/23 in contrast with the earlier yr. Meningococcal illness is the collective identify given to illness brought on by Neisseria meningitidis. An infection with this micro organism may end up in both meningitis or septicaemia (generally generally known as blood poisoning) or each.
Meningitis can progress quickly leaving survivors with severe well being issues resembling mind harm and listening to loss. Early prognosis is important to cut back the dangers however this may be difficult (see latest article within the British Medical Journal). The Nationwide Institute for Well being and Care Excellence (NICE) up to date its steerage for clinicians in relation to bacterial meningitis and meningococcal illness in 2024. Charity Meningitis Now believes these new tips could also be a vital turning level. Right here I take a look on the key points from my perspective as a specialist scientific negligence lawyer who works with shoppers affected by delays within the prognosis of those situations.
Meningitis is an irritation of the protecting membranes overlaying the mind and spinal wire. It may be brought on by micro organism, viruses or fungi. Bacterial meningitis is essentially the most extreme type. An infection with neisseria meningitidis (meningococcal illness) is the commonest explanation for bacterial meningitis and as much as ten p.c of instances lead to demise. It may happen at any age however infants and younger kids are most in danger, with the subsequent most weak group being youngsters and younger adults.
Earlier NICE tips on this space coated solely kids below 16. The up to date tips now additionally cowl younger individuals and adults – an essential improvement in my opinion.
These tips set out that clinicians ought to have a ‘robust suspicion’ of bacterial meningitis when individuals have the next mixture of crimson flag signs: fever, headache, neck stiffness and an altered degree of consciousness or cognition.
For meningococcal illness itself there needs to be a robust suspicion when any of the next current: a haemorrhagic, non-blanching rash with lesions bigger than 2mm, a quickly progressing / spreading non-blanching or purpuric rash and any signs of bacterial meningitis when mixed with such a rash. Nevertheless, it’s clearly said that meningococcal illness shouldn’t be dominated out as a result of there is no such thing as a rash.
On examination, the entire physique needs to be checked for a rash which, it’s famous, could be tough to detect on black, brown or tanned pores and skin. Consequently the rules state that there needs to be a test for petechiae (pin-point sized spots of bleeding) within the conjunctiva.
The rules flag that altered behaviour in younger individuals and younger adults could be incorrectly assumed to be brought on by alcohol or substance abuse and this could result in bacterial meningitis or meningococcal illness being missed.
Folks with suspected bacterial meningitis or meningococcal illness needs to be transferred to hospital as an emergency. The rules element the circumstances wherein antibiotics needs to be given earlier than arrival at hospital, together with the place meningococcal illness is strongly suspected until this may trigger a delay in switch to hospital.
Having arrived at hospital there needs to be an preliminary evaluation by a senior scientific determination maker who ought to be certain that intravenous antibiotics begin inside one hour of arrival. Blood checks and a lumbar puncture (the place protected to take action) needs to be carried out earlier than beginning antibiotics for suspected bacterial meningitis. For suspected meningococcal illness, blood checks needs to be carried out earlier than antibiotics start. For each situations there needs to be a bacterial throat swab taken, ideally earlier than antibiotics are began.
The up to date tips don’t cowl all strains of meningitis excluding for instance viral meningitis and neonatal meningitis.
The place NICE tips haven’t been adopted, or there have been different failings, resulting in a delay within the prognosis and remedy, it could be attainable to convey a declare for scientific negligence. With a view to profitable with such a declare, it should be proven that any delay was negligent and in addition that earlier remedy would have modified the result. This typically requires the enter of a number of consultants together with within the fields of microbiology and neurology. A specialist medical negligence solicitor will be capable to advise absolutely.
If you want to talk to our pleasant and delicate staff for a no obligation dialogue then please contact us on 020 7814 1200 or by way of our contact us web page.
Additional info
If you will have any questions concerning this weblog, please contact Rebecca Linnell in our Medical Negligence and Private Damage staff.
In regards to the creator
Rebecca is an Affiliate within the Medical Negligence Division who acts for a spread of shoppers coping with each medical negligence and private harm claims. She assists the Companions within the Division with complicated claims together with negligence referring to spinal accidents, delivery accidents, obstetric accidents, ophthalmic accidents and instances the place there was a fatality. She additionally has expertise in coping with points surrounding affected person consent and delays in prognosis. Rebecca moreover assists shoppers who’ve sustained catastrophic accidents from highway visitors accidents.
