New knowledge from the UK Well being Safety Company (UKHSA) reveals a vital rise in circumstances of invasive meningococcal illness (IMD) throughout England throughout 2022/23 in contrast with the earlier 12 months. Meningococcal illness is the collective identify given to illness attributable to Neisseria meningitidis. An infection with this micro organism can lead to both meningitis or septicaemia (generally generally known as blood poisoning) or each.
Meningitis can progress quickly leaving survivors with critical well being problems equivalent to mind harm and listening to loss. Early analysis is significant 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 steering 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 medical negligence lawyer who works with shoppers affected by delays within the analysis of those circumstances.
Meningitis is an irritation of the protecting membranes overlaying the mind and spinal wire. It may be attributable to micro organism, viruses or fungi. Bacterial meningitis is essentially the most extreme kind. An infection with neisseria meningitidis (meningococcal illness) is the commonest reason for bacterial meningitis and as much as ten p.c of circumstances end in loss of life. It could actually happen at any age however infants and younger kids are most in danger, with the following most susceptible group being youngsters and younger adults.
Earlier NICE tips on this space coated solely kids underneath 16. The up to date tips now additionally cowl younger individuals and adults – an necessary improvement for my part.
These tips set out that clinicians ought to have a ‘robust suspicion’ of bacterial meningitis when individuals have the next mixture of purple flag signs: fever, headache, neck stiffness and an altered degree of consciousness or cognition.
For meningococcal illness itself there ought to be a powerful 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. Nonetheless, it’s clearly acknowledged that meningococcal illness shouldn’t be dominated out as a result of there isn’t a rash.
On examination, the entire physique ought to be checked for a rash which, it’s famous, might be tough to detect on black, brown or tanned pores and skin. Consequently the rules state that there ought 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 might be incorrectly assumed to be attributable to alcohol or substance abuse and this could result in bacterial meningitis or meningococcal illness being missed.
Folks with suspected bacterial meningitis or meningococcal illness ought to be transferred to hospital as an emergency. The rules element the circumstances through which antibiotics ought to be given earlier than arrival at hospital, together with the place meningococcal illness is strongly suspected except this is able to trigger a delay in switch to hospital.
Having arrived at hospital there ought to be an preliminary evaluation by a senior medical resolution maker who ought to be sure that intravenous antibiotics begin inside one hour of arrival. Blood assessments and a lumbar puncture (the place protected to take action) ought to be carried out earlier than beginning antibiotics for suspected bacterial meningitis. For suspected meningococcal illness, blood assessments ought to be carried out earlier than antibiotics start. For each circumstances there ought 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 analysis and remedy, it might be doable to carry a declare for medical negligence. With a purpose to profitable with such a declare, it have to be proven that any delay was negligent and in addition that earlier remedy would have modified the end result. This usually requires the enter of a number of specialists together with within the fields of microbiology and neurology. A specialist medical negligence solicitor will have the ability to advise absolutely.
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If you’ve any questions concerning this weblog, please contact Rebecca Linnell in our Medical Negligence and Private Harm staff.
In regards to the writer
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 regarding spinal accidents, beginning accidents, obstetric accidents, ophthalmic accidents and circumstances the place there was a fatality. She additionally has expertise in coping with points surrounding affected person consent and delays in analysis. Rebecca moreover assists shoppers who’ve sustained catastrophic accidents from highway site visitors accidents.