New information from the UK Well being Safety Company (UKHSA) reveals a important 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 can lead to both meningitis or septicaemia (generally often called blood poisoning) or each.
Meningitis can progress quickly leaving survivors with severe well being problems corresponding to mind harm and listening to loss. Early prognosis is significant to scale back the dangers however this may be difficult (see current 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 important turning level. Right here I take a look on the key points from my perspective as a specialist medical negligence lawyer who works with purchasers affected by delays within the prognosis of those circumstances.
Meningitis is an irritation of the protecting membranes masking the mind and spinal twine. It may be brought on by micro organism, viruses or fungi. Bacterial meningitis is probably 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 will probably 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 folks and adults – an vital improvement in my opinion.
These tips set out that clinicians ought to have a ‘robust suspicion’ of bacterial meningitis when folks 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 acknowledged that meningococcal illness shouldn’t be dominated out as a result of there isn’t any rash.
On examination, the entire physique needs to be checked for a rash which, it’s famous, could be troublesome to detect on black, brown or tanned pores and skin. In consequence the rules state that there needs to be a examine for petechiae (pin-point sized spots of bleeding) within the conjunctiva.
The rules flag that altered behaviour in younger folks and younger adults could be incorrectly assumed to be brought on by alcohol or substance abuse and this will 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 during which 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 medical choice maker who ought to make sure 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 circumstances 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 might be attainable to deliver a declare for medical negligence. With a view to profitable with such a declare, it have to be proven that any delay was negligent and likewise that earlier remedy would have modified the result. This typically requires the enter of a number of specialists together with within the fields of microbiology and neurology. A specialist medical negligence solicitor will be capable to advise totally.
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If you’ve any questions concerning this weblog, please contact Rebecca Linnell in our Medical Negligence and Private Harm workforce.
Concerning the writer
Rebecca is an Affiliate within the Medical Negligence Division who acts for a spread of purchasers coping with each medical negligence and private damage claims. She assists the Companions within the Division with complicated claims together with negligence regarding spinal accidents, beginning 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 purchasers who’ve sustained catastrophic accidents from street visitors accidents.
